Keywords: pharmacology (PubMed Search)
Posted: 1/23/2014 by Fermin Barrueto, MD
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Everyone has admitted an altered mental status, patient or bradycardic patient and all of your test results are coming back normal except for a mild increase in creatinine. Take a look at the medication list. Creatinine is a poor indicator of renal function and GFR may be severely impaired even with a mild elevation of creatinine. If you have a predominantly renally excreted drug, you can see toxic effects of a drug even if administered at therapeutic levels.
Common bradycardia inducing medication that is renally cleared: atenolol (very high renal excretion) and digoxin (70%).
Altered Mental Status and on Keppra? Keppra is 100% renally cleared!
Ask your pharmacist for help with the medication list with renal or hepatic insufficiency.
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