Related kidney disease experts point out that the pharmacology of uremic patients is different from that of ordinary people. There are endless cases, such as patients with renal insufficiency who take uric acid lowering drugs and have their skin fall off and die, those who inject penicillin and cause epilepsy, and those who take muscle relaxants become unconscious. Not only does this make non kidney specialist doctors see uremic patients as hot headed, but patients themselves often feel at a loss.
The absorption of drugs by renal failure patients is difficult to grasp due to prolonged gastric emptying after oral administration and poor absorption during intramuscular injection. Even after successful absorption, the uremic patient will have water accumulated in the body, making the concentration of drugs in the body become insufficient. In addition, repeated dialysis will also make some drugs filtered out from the artificial kidney. Due to the difficulty of drugs binding to proteins caused by urinary toxins, many drugs can cause poisoning in uremic patients at normal doses, such as stopping breathing when injected with normal doses of anesthesia painkillers and antiepileptic drugs. Even if some drugs metabolized by the liver are not excreted through the kidneys, there may be cases of impaired liver function in patients. It is still necessary to carefully consider the dosage. If the dosage is not reduced, it often leads to abnormal liver function in uremic patients.
The most disturbing thing is that the uremic patients take the old drugs they have taken in the past according to their own judgment, but the uremic patients do not know that the required dose will vary with the changes in renal function. For example, the use of insulin by patients with diabetes nephropathy will gradually reduce the demand with the deterioration of renal function. If they still use the same dose six months ago, it will lead to hypoglycemia coma and even become a vegetable. So the key to medication for uremic patients lies in the word 'caution'.