Chennavasin P, Brater D C
Clin Pharmacokinet. 1981 May-Jun;6(3):193-214. doi: 10.2165/00003088-198106030-00002.
The medical literature is replete with dosing guidelines for patients with renal dysfunction. Altering dosing regimens in such patients is particularly important with drugs with a narrow therapeutic index, such as digoxin and the aminoglycoside antibiotics. A variety of methods have been used to devise dosing nomograms. This article reviews the salient features of different methods, and addresses the issues of predictability or unpredictability in attaining desired plasma concentrations of drug. It is suggested that therapy must be individualised, and that the clinician can best plan his therapy by understanding the principles on which dose adjustment is based, rather than using the same nomogram or guideline for each and every patient.
医学文献中充斥着针对肾功能不全患者的给药指南。对于治疗指数较窄的药物,如地高辛和氨基糖苷类抗生素,在这类患者中调整给药方案尤为重要。人们使用了多种方法来设计给药剂量图表。本文回顾了不同方法的显著特点,并探讨了在达到所需药物血浆浓度方面的可预测性或不可预测性问题。建议治疗必须个体化,临床医生最好通过理解剂量调整所依据的原则来规划治疗方案,而不是对每个患者都使用相同的剂量图表或指南。