| Theme | The consideration of polypharmacy in dialysis patients | |
|---|---|---|
| Title | Prescription of digestive disease treatment drugs | |
| Publish Date | 2017/04 | |
| Author | Shuji Iwatsubo | First Department of Internal Medicine, Faculty of Medicine, University of Miyazaki |
| Author | Shouichi Fujimoto | First Department of Internal Medicine, Faculty of Medicine, University of Miyazaki / Department of Hemovascular Medicine and Artifi cial Organs, Faculty of Medicine, University of Miyazaki |
| [ Summary ] | In dialysis patients, therapeutic drugs for peptic ulcer and constipation are occasionally prescribed. Proton pump inhibitors (PPIs) do not require dose adjustment in dialysis patients, because they are metabolized by the liver. On the contrary, H2 receptor blocker (H2RA) dosage must be reduced in dialysis patients. Clarithromycin (CAM), used as a treatment for H. pylori infection, is a CYP3A4 inhibitor. When using CAM, attention must be paid to concomitant drugs. Dialysis patients are often constipated, and therefore, it must be determined whether the drug being prescribed may cause constipation. When prescribing phosphate binders and ion-exchange resins, which may cause constipation, treatment for the prevention of constipation must be considered. | |