Prescription audit of renally excreted drugs and vancomycin dosing for older patients with reduced kidney function

Abstract

Japan has the largest aging population in the world, and kidney function declines with age. Therefore, when administering renally excreted drugs to older patients, the dosage should be adjusted according to the kidney function. This study addresses the appropriate use of renally excreted drugs in older patients in two topics. The first topic is concerned with the author’s experience with cibenzoline overdose, which led the author to conduct a survey of renally excreted drugs and establish an in-hospital prescription checking system for these drugs. The second topic clarifies the usefulness of serum creatinine-based kidney function estimation equations for predicting the area under the concentration-time curve of vancomycin in bedridden older patients. Based on these findings, the importance of pharmaceutical interventions by pharmacists in the pharmacotherapy of older patients with reduced kidney function is discussed