Attention to the application of antibacterial drugs for patients with kidney deficiencies
The kidney, as an important excretion organ of the human body, is responsible for the removal of metabolic waste and excess water from the body and is also involved in the metabolic and excretion of drugs. However, when the kidney function is incomplete, the excretion of the drug is seriously affected, leading to its accumulation in the body, thus increasing the risk of adverse effects. Reasonable choice of the drug, adjustment of the dose and monitoring of the kidney function are essential for patients with incomplete kidney function requiring the use of antibacterial drugs.
I. Effects of insufficiency of kidneys against the discharge of bacterial drugs
Incomplete kidney function, reduced renal filtration and excretion, leading to the accumulation of antibacterial drugs and their metabolites in the body, may cause a series of adverse reactions. These adverse effects include kidney toxicity, hepatotoxicity, neurotoxicity, etc., and even life-threatening when severe.
1. Avoiding the use of antibacterials with high kidney toxicity: Incomplete kidneys should avoid, as far as possible, the use of antibacterials with apparent kidney toxicity, such as aminocin slurry (Kingacin, Cannacin, etc.) and sexcin B. The high concentrations of these drugs in the kidneys can easily cause kidney damage. 2. Choosing antibacterials with low or no kidney toxicity: Patients with incomplete kidney function may choose some antibacterials with less or no kidney toxicity, such as penicillin (pencin V potassium tablets, Amosicillin, etc.), headgillin (furancin, corrosion, etc.), large ringed esters (erythrin, Achicillin, etc.). These drugs are mainly metabolized in the liver or co-renal and liver, with relatively small kidney damage. 3. Renal function-adjusted dose: In the case of antibacterial drugs, the patient with incomplete kidney function should adjust the dose to the kidney function. For drugs that are mainly excreted through kidneys, such as β-neamide (pentacin, septactin, etc.), the dose should be adjusted to the serocelline acetic anhydride or acetic anhydride removal rate. For drugs mainly metabolized through the liver, such as the large rim ester drug, no dose adjustment is generally required.
1. Monitoring of the kidney function: During the use of antibacterial drugs, patients with incomplete kidney function should regularly monitor the kidney function, including indicators such as serum acetic anhydride and urea nitrogen, in order to detect changes in the kidney function in a timely manner and to adjust the treatment programme. 2. Maintaining adequate water intake: Persons with incomplete kidneys should maintain sufficient water intake to facilitate the excretion of drugs and reduce their accumulation in the kidneys. At the same time, it is necessary to avoid long-term holding of urine in order not to aggravate the condition. 3. Refrain from co-locating with other kidney-toxic substances: When using antibacterials, patients with incomplete kidneys should avoid co-locating with other renal-toxic substances, such as non-polymeric anti-inflammation drugs (defuncts), film-making agents, etc., in order not to increase the kidney burden. 4. Attention to drug interactions: Certain antibacterial drugs may interact with other drugs, affecting their metabolism and excretion. Therefore, before using antibacterial drugs, the patient should inform the doctor of his or her own history of medication and allergies, so that the doctor can choose the appropriate drug and adjust the dose.
Summary
Patients with incomplete kidney function should be fully informed of the renal toxicity and metabolic pathways of the drug when using antibacterial drugs, and choose the appropriate drug and adjust the dose according to the kidney function. At the same time, attention is paid to the monitoring of kidney functions, the maintenance of adequate water intake, the avoidance of co-use with other renal toxicity drugs and the interaction of drugs. Only in this way can the safety and effectiveness of antibacterial drugs be ensured and the occurrence of adverse reactions be reduced.
Kidney failure.
