WS4: Drug dosing adjustment in dialysis patients

Sara Kenda, General Hospital "Dr. Franc Derganc" Nova Gorica, Slovenia
Tomaž Vovk, Faculty of Pharmacy, University of Ljubljana, Slovenia

Background:

Clinical pharmacists are part of the health care team aiming to optimize pharmacotherapy in the target population. Patients with renal failure represent a challenging group since impaired drug elimination can lead to elevated drug concentrations and consequently higher susceptibility to adverse drug events. Changed pharmacokinetics and pharmacodynamics in patients with renal failure require a suitable approach to dosing drugs to achieve the desired results of treatment. For appropriate drug dosing clinical pharmacists use summaries of product characteristics, different literature about drug elimination during dialysis and pharmacokinetics programmes.

Target audience:

The aim of a workshop is to highlight the important pharmacokinetic and pharmacodynamic changes in patients with renal failure, to present types of dialysis and identify the critical conditions of patients that affect the pharmacokinetics and pharmacodynamics of drugs. The workshop will hand out the tools for drug dosing optimisation in dialysis patients.

Learning Objectives:

After the workshop participants will be able to:
- identify pharmacokinetic and pharmacodynamics changes in patients with renal failure,
- distinguish between different types of dialysis,
- apply basic concepts of drug removal during different types of dialysis to specific situations.

Content and Structure:

Proposal of the 90 minute workshop time schedule:
20min
Moderators present objectives about different types of dialysis (hemodialisys (HD), hemofiltration (HF), hemodiafiltration (HDF), continuous HD, HF and HDF, peritoneal dialysis (CAPD)), changes in pharmacokinetics and pharmacodynamics in patients with renal failure and literature that the participants will need during the workshop.
40min
Moderators will divide five cases between workshop participants; no more than 6 people work on one case. Proposed cases:
1. Septic shock; appropriate dosing of antibiotics during continuous HD
2. Septic shock; appropriate dosing of antibiotics during HDF
3. Dosing of cardiovascular therapy in patients on HD (three times a week)
4. Dosing of cardiovascular therapy in patients on CAPD
5. Patient on HD (three times a week) and acute pain
30min
Participants will present their cases and moderators will guide the discussion.

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