Thursday, February 15, 2018

Drug level monitoring in ICU

Q: End-stage renal disease (ESRD) and AKI can also effect hepatic drug metabolism?

A) True
B) False


Answer: True

An important but not always appreciated fact in the ICU is that liver drug metabolism may also change in patients who develop acute kidney injury (AKI). Overall, end-stage renal disease (ESRD) and AKI both reduce hepatic drug metabolism. It calls for close vigilance of drugs level monitoring, irrespective of route of excretion.


Reference:

1. Vilay AM, Churchwell MD, Mueller BA. Clinical review: Drug metabolism and nonrenal clearance in acute kidney injury. Crit Care 2008; 12:235. 

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