Original Research
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction:
Inclusion of numeric, actionable renal dosing recommendations in drug information (DI) resources enhances the safe use of nephrotoxins.
Research Question or Hypothesis:
The purpose of this study was to characterize renal dose recommendations in 4 common DI resources.
Study Design:
Systematic, descriptive comparison of tertiary DI resource content.
Methods:
A list of nephrotoxins (N=153) was generated from previously published lists that individually focused on adult critical care (n=94), hospitalized children (n=52), and primary care/geriatrics (n=52). Renal dosing information was collected for each drug from the package insert, Lexi-comp, Micromedex, and Clinical Pharmacology. Dosing recommendations were categorized using a 6-category scale (numeric [ie, dosing or statement to avoid with a measure of renal function], nonnumeric [ie, use caution or monitor closely without specific dosing or renal function cutoffs], contraindicated, no dose adjustment required, no recommendation, drug missing from the source).
Results:
Actionable renal impairment recommendations (numeric, non-numeric, contraindicated, no dose adjustment required) in the package insert, Lexi-comp, Micromedex, and Clinical Pharmacology were 87.6%, 97.4%, 94.1%, and 98.7%, respectively. Numeric recommendations were available for 53.6% to 75.2% of medications, depending on the source. Actionable recommendations for hemodialysis, peritoneal dialysis, continuous renal replacement, and hybrid dialysis modalities were most common in Lexi-comp (79.1%, 72.5%, 58.8%, and 49.7% of medications, respectively). Actionable pediatric (71.2%) and geriatric (41.2%) recommendations were most common in Lexi-comp and Clinical Pharmacology, respectively. Geriatric recommendations were generally nonnumeric (78.3% to 100% of geriatric recommendations). Actionable recommendations for adult critical care, hospitalized children, and primary care medications were prevalent (87.2% to 100%, 86.5% to 96.2%, and 98.1% to 100%) and were mainly numeric.
Conclusion:
DI resources included actionable renal dosing recommendations for most known nephrotoxins. Numeric recommendations for renal replacement, pediatric, and geriatric settings were generally lacking. Resource publishers are urged to include numeric, actionable renal dosing content, when available.
Presenting Author
Heather J. Ipema PharmD, BCPSAuthors
Ruba Alomari PharmD Candidate
University of Illinois at Chicago
Erika Maslennikov PharmD Candidate
University of Illinois Chicago
Trisha Hartke PharmD, BCPS
University of Illinois Chicago
Faria Munir PharmD, MS
University of Illinois Chicago
Anna Dazy PharmD Candidate
University of Illinois Chicago
Alexandra Wierzbiak PharmD Candidate
University of Illinois Chicago