Intradialytic clearance of opioids: methadone versus hydromorphone.
Clinical pharmacists can deliver safer and more efficacious drug therapy to end-stage renal patients with knowledge and application of the pharmacokinetics of haemodialysis. The physical, chemical and pharmacokinetic properties of a drug will determine its degree of dialysability. These properties included water solubility, molecular weight, protein binding, volume of distribution, and the fraction, route and rate of drug elimination. Various dialysis-induced metabolic alterations must also be considered. With an understanding of these factors, the pharmacist can determine whether dosage adjustments are necessary and, if so, make the required calculations accurately.