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Renal clearance, of drugs

Renal clearance of drugs is delayed in newborns and young infants, necessitating dose reductions (Figure 23.7), but after 8 to 12 months of age, renal excretion of drugs is comparable with that of older children and may even exceed that of adults. In young... [Pg.366]

FIGURE 34.8 Distribution of the main drug ABC (green) and SLC (pink) transporters on the basola-teral (peritubular fluid) and apical (glomerular filtrate) membranes of the kidney proximal tubule cells. Active secretion and reabsorption help to define the overall renal clearance of drugs and xenobiotics. [Pg.708]

Maiza A, Daley-Yates PT. Estimation of the renal clearance of drugs using endogenous N-1-methylnicotinamide. Toxicol Lett 1990 53 231-235. [Pg.780]

Tucker, G. I. (1984). Measurement of the renal clearance of drugs. British Journal of Clinical Pharmacology, 12, 761—770. [Pg.199]

IMPAIRED RENAL CLEARANCE OF DRUGS If a drug is cleared primarily by the kidney, dose modification should be considered in patients with renal dysfunction. When renal clearance is diminished, the desired effect can be maintained either by decreasing the dose or lengthening the dose interval. Estimation of the glomerular filtration rate (GFR) based on serum creatinine, ideal body weight, and age provides an approximation of the renal clearance of many drugs. [Pg.73]

Strategies for prediction of Fa and Fg are explained in Section 6.3 and F is calculated from CL/,. In the following section, general strategies for predicting hepatic and renal clearance of drugs are described. [Pg.212]

The renal excretion of drugs depends on glomerular filtration, tubular secretion, and tubular absorption. A twofold increase in glomerular filtration occurs in the first 14 days of life [36], The glomerular filtration rate continues to increase rapidly in the neonatal period and reaches a rate of about 86 mL/min per 1.73 m2 by 3 months of age. Children 3-13 years of age have an average clearance of 134 mL/min per 1.73 m2 [37]. Tubular secretion approaches adult values between 2 and 6 months [11], There is more variability observed in maturation of tubular reabsorption capacity. This is likely linked to fluctuations in urinary pH in the neonatal period [38],... [Pg.668]

Drugs that decrease renal clearance of uric acid through modification of filtered load or one of the tubular transport processes include diuretics, nicotinic acid, salicylates (less than 2 g/day), ethanol, pyrazinamide, levodopa, ethambutol, cyclosporine, and cytotoxic drugs. [Pg.15]

In practice problem 2, if the renal clearance of the drug is found to be 18 L per hour, what would be the non-renal clearance of the drug ... [Pg.256]

Kidney failure not only decreases renal clearance of nicotine and cotinine, but also metabolic clearance of nicotine (Molander et al. 2000). Metabolic clearance of nicotine is reduced by 50% in subjects with severe renal impairment compared to healthy subjects. It is speculated that accumulation of uremic toxins may inhibit CYP2A6 activity or downregulate CYP2A6 expression in liver. Hepatic metabolism of several drugs is reduced in kidney failure, mainly via downregulation of CYP enzymes and/or inhibition of transporters (Nolin et al. 2003). [Pg.43]

However, the major contributing factor to the decreased renal clearance of total drug was increasing plasma protein binding with increasing lipophilicity. When the extent of plasma protein binding was taken into account, the imbound renal clear-... [Pg.69]

Approximately 16 % of the dose is hydroxylated, 5.8 % at the 5 position (SOH) and 10.2 % at 6 position (SCH2OH). No glucuronide metabolites were formed. Acetylation accounted for 12.7 % of the dose, while the recovery of the parent drug was 13.9 %. Thus approximately 58 % of the administered dose is lost after i.v. application (Table III). The renal clearance of the hydroxy and acetylated metabolites were 10 to 50 fold higher than that of SDM. [Pg.179]

Excretion - The terminal elimination half-life is between 5 and 6 days following inhalation. After dry powder inhalation, urinary excretion is 14% of the dose, the remainder being mainly nonabsorbed drug in the gut, which is eliminated via the feces. The renal clearance of tiotropium exceeds the Ccr, indicating active secretion into the urine. After chronic, once-daily inhalation by COPD patients, pharmacokinetic steady state was reached after 2 to 3 weeks with no accumulation thereafter. [Pg.764]

Excretion - Excretion of caspofungin and its metabolites in humans was 35% in feces and 41% in urine. A small amount of caspofungin is excreted unchanged in urine (approximately 1.4% of dose). Renal clearance of parent drug is low (approximately 0.15 mL/min), and total clearance of caspofungin is 12 mL/min. [Pg.1692]

Pharmacokinetics What the patient does to the drug. For example, a patient with renal failure will have diminished renal clearance of gentamicin. [Pg.510]

The potential for drug interactions, particularly with other drugs that are actively secreted by the proximal tubules, should be considered. Probenecid has been shown to inhibit the renal clearance of acyclovir. Cyclosporine and other nephrotoxic agents may increase the risk of renal toxicity of acyclovir. [Pg.570]


See other pages where Renal clearance, of drugs is mentioned: [Pg.189]    [Pg.284]    [Pg.668]    [Pg.54]    [Pg.377]    [Pg.378]    [Pg.235]    [Pg.248]    [Pg.109]    [Pg.5]    [Pg.295]    [Pg.5]    [Pg.5]    [Pg.176]    [Pg.324]    [Pg.2880]    [Pg.189]    [Pg.284]    [Pg.668]    [Pg.54]    [Pg.377]    [Pg.378]    [Pg.235]    [Pg.248]    [Pg.109]    [Pg.5]    [Pg.295]    [Pg.5]    [Pg.5]    [Pg.176]    [Pg.324]    [Pg.2880]    [Pg.362]    [Pg.1285]    [Pg.193]    [Pg.502]    [Pg.889]    [Pg.68]    [Pg.10]    [Pg.179]    [Pg.180]    [Pg.179]    [Pg.1769]    [Pg.199]    [Pg.152]    [Pg.162]    [Pg.188]    [Pg.256]    [Pg.61]   
See also in sourсe #XX -- [ Pg.4 , Pg.5 , Pg.5 ]




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