ROLE OF CLINICAL PHARMACIST IN DOSE ADJUSTMENT OF RENALLY ELIMINATED DRUGS IN CARDIAC PATIENTS WITH RENAL IMPAIRMENT

Abstract

Introduction: Clinical pharmacist role in dose adjustment of renally eliminated drugs is crucial to prevent or decrease drug-related adverse events and eventually decrease hospitalization and costs. Materials and method: to address correct dosing and the avoidable adverse events, the incidence of renal impairment following cardiac surgery was evaluated to guide the pharmacist and the cost impact of dose adjustment were calculated accordingly. Clinical outcome will not be assessed since the adverse event were avoided by dose adjustment. Result and discussion: from all admitted patients to 160-full bed capacity tertiary hospital for different cardiac procedures, eighty-eight met the inclusion criteria and followed for four weeks. Only 35.6% preserved normal kidney function while the rest developed acute renal impairment. Dose adjustment was recommended for 13.8% of the patients and involved six drugs. all dose recommendations were agreed by the physicians with estimated annual saving of 384,358 Saudi riyals. Conclusion: clinical pharmacist monitoring prescriptions for dosing error decreases the total cost and may prevents incidence of drug related adverse effects.

KEY WORDS: Clinical pharmacy, Intervention, Dosing, Pharmaceutical care.

Introduction: Clinical pharmacist role in dose adjustment of renally eliminated drugs is crucial to prevent or decrease drug-related adverse events and eventually decrease hospitalization and costs. Materials and method: to address correct dosing and the avoidable adverse events, the incidence of renal impairment following cardiac surgery was evaluated to guide the pharmacist and the cost impact of dose adjustment were calculated accordingly. Clinical outcome will not be assessed since the adverse event were avoided by dose adjustment. Result and discussion: from all admitted patients to 160-full bed capacity tertiary hospital for different cardiac procedures, eighty-eight met the inclusion criteria and followed for four weeks. Only 35.6% preserved normal kidney function while the rest developed acute renal impairment. Dose adjustment was recommended for 13.8% of the patients and involved six drugs. all dose recommendations were agreed by the physicians with estimated annual saving of 384,358 Saudi riyals. Conclusion: clinical pharmacist monitoring prescriptions for dosing error decreases the total cost and may prevents incidence of drug related adverse effects.