Adjustment of drug dosage according to glomerular filtration rate in elderly people admitted to intensive care units
DOI:
https://doi.org/10.30968/jhphs.2025.162.1272Abstract
Objective: This study aimed to evaluate dose adjustment based on glomerular filtration rate in elderly patients admitted to Intensive Care Units. Methods: This is a retrospective cross-sectional study conducted with patients aged ≥ 60 years admitted to Intensive Care Units of a public hospital. To evaluate medications requiring dose adjustment according to glomerular filtration rate (GFR), the first prescription after 48 hours of ICU admission was considered. All medications requiring dose adjustment based on GFR were evaluated throughout the patient’s hospitalization period in the ICU, as well as creatinine tests for calculating GFR on the day of medication use, to assess the need for dose adjustment individually for each medication. Results: Among the 189 patients analyzed, 757 medications requiring dose adjustment based on GFR were identified, distributed among 38 different drugs. Of these, 55.4% actually required adjustment during hospitalization, but only 16.7% received dose adjustment. Of the prescribed medications that require dose adjustment based on glomerular filtration rate and did not receive this adjustment: 68.9% were for patients with nephropathy, 84.4% for patients with altered creatinine who died, 73.3% for patients who underwent hemodialysis, 86.8% for patients who were evaluated by a pharmacist, and 74.7% for patients who were evaluated by a nephrologist. Conclusion: This study identified that dose adjustment based on glomerular filtration rate in elderly patients admitted to the ICU was mostly performed for antibiotics, leaving other medications that act on the cardiovascular, digestive, and metabolic systems without dose adjustment.
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