Drug-Related Problems and Sick Day Management Considerations for Medications that Contribute to the Risk of Acute Kidney Injury.

Autor: Truong M; School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia., Tesfaye W; School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia., Sud K; Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia.; Nepean Kidney Research Centre, Department of Renal Medicine, Nepean Hospital, Nepean and Blue Mountains Local Health District, Kingswood 2747, Australia., Van C; School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia., Seth S; Manipal Academy of Higher Education (MAHE), The University of Sydney, Sydney 2006, Australia., Croker N; Meditrax, Drummoyne 2047, Australia., Castelino RL; School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia.; Pharmacy Department, Blacktown Hospital, WSLHD, Blacktown 2148, Australia.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2024 Jan 07; Vol. 13 (2). Date of Electronic Publication: 2024 Jan 07.
DOI: 10.3390/jcm13020343
Abstrakt: Background: Medication use during acute illness increases the risk of experiencing drug related problems (DRPs), including acute kidney injuries. It is recommended that potentially nephrotoxic medications are withheld during acute illness, including sulfonylureas, angiotensin converting enzyme inhibitors, diuretics, metformin, angiotensin receptor blockers, non-steroidal anti-inflammatories and sodium glucose co-transporter 2 inhibitors (SADMANS). It is unknown if Australian pharmacists currently provide sick day medication management advice regarding SADMANS medications. Hence, we aimed to identify current DRPs and the recommendations made during residential medication management reviews (RMMRs), especially with SADMANS medications.
Methods: A retrospective review of 408 RMMRs was conducted. DRPs and pharmacist recommendations were classified according to a modified DOCUMENT system. General practitioners' (GP) recommendations were also categorised.
Results: Over 97% of residents experienced at least one DRP. Common problems for non-SADMANS medications were "toxicity or adverse drug reaction", "drug selection" and "over/underdosing" and those for SADMANS medications included "toxicity or adverse drug reaction", "monitoring" and "drug selection". GPs agreed with pharmacist recommendations approximately 40% of the time. No pharmacists provided sick day medication management advice for SADMANS medications.
Conclusion: DRPs remain highly prevalent in aged care facilities. Medication reviews effectively identify and resolve DRPs approximately 40% of the time, but do not currently minimise the risk associated with using SADMANS medications during sick days, which is a potential area of improvement.
Databáze: MEDLINE
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