Preferred Abstract (Original):
Background and Aim Reduced renal function requires dose adjustment for certain drugs to avoid toxicity. The aim of this
study was to determine whether appropriate dosage adjustments were made for drugs that are nephrotoxic, excreted, or
metabolized (TEM medications) by the kidney in patients with renal impairment.
Methodology A cross-sectional study of a group of hospitalized patients was carried out at Al-Watni governmental
hospital, Nablus, Palestine. All patients with creatinine clearance 59 ml/min were included in the analysis. Data regarding
patients’ clinical, laboratory findings and medications whether they were prescribed at hospital or at discharge were collected
from patients’ medical files. Evaluation of appropriate dosing was based on Physician Disk Reference (PDR). All data were
collected for further research and subsequent statistical analysis using statistical package for social sciences (SPSS) for
windows version 10.
Results A total of 78 patients had calculated creatinine clearance 59 ml/min. Those patients were prescribed a total of
1001 lines of prescription medication. Dosage adjustment was necessary for 193 TEM medications. Analysis of TEM
medications with guidelines for adjustment indicated that 73.58%(142) were found to be inappropriate and 26.42% (51) were
found to be appropriate. The most common inappropriate medications were ranitidine, antibiotics, and digoxin. Approximately
77.5% of the unadjusted medications were prescribed during hospitalization.
Conclusion In our study, a wide range of dosing errors was common among patients with renal impairment that was
common during hospitalization. Continued medical education in the field of clinical pharmacokinetics is important for
physicians. Copyright # 2007 John Wiley & Sons, Ltd.