In this section : Renal
Diagnosis, treatment and management of UTI in children (D&G)
Kidney Biopsy Complications
Parenteral Iron for Non-HD CKD Patients
Management of uncomplicated Henoch-Schonlein Purpura (HSP) in under 16s
Prescribing Advice on Admission – Insulin
Sodium Glucose Transporter 2 Inhibitors (SGLT2i)
Gentamicin in Renal Replacement Therapy
Vancomycin in Renal Replacement Therapy
Haemodialysis Medication Prescribing
Contrast Associated AKI
Low Molecular Weight Heparin
Fluid Replacement in AKI
Management of Urinary Symptoms
Acute Kidney Injury (AKI)
Urinary Tract Infection
Urethral Catheterisation
Kidney Transplantation
Ureteric Colic & Renal Stones
Intravascular Catheter Related Blood Stream Infection
Care of Vascular Access
Urinary Incontinence
Peritoneal Dialysis Related Peritonitis
Haemodialysis Medication Prescribing
Last updated 3rd December 2020
Introduction
- Our Haemodialysis patients usually come to Mountainhall Treatment centre or Stranraer renal unit Mon/Wed/Friday or Tuesday/Thursday/Saturday for their therapy. Some come twice weekly.
- They have some medications every session, some weekly, some as required and sometimes need one off doses. These are prescribed via HEPMA. As far as HEPMA is concerned they are inpatients in the renal unit and can be found easily by typing the start of the surname and then entering “renal” as the location into HEPMA.
- When a patient is discharged from hospital they will be re-admitted to renal on HEPMA. At this point they need their DIALYSIS medications re-prescribed. This DOES NOT mean: prescribe all the medication the patient has been on while in hospital / all the medications on their ECS.
How to Restart Dialysis Medications
- Type ‘renal’ into location on HEPMA.
- Find and select the patient.
- Open inpatient prescribing record to view previous episodes
- Select either their hospital admission (if the admission involved haemodialysis meds) OR their last admission to the renal unit (usually there will be a long span of dates for this).
- Once this is selected go to view episode then you will see a list of medicines.
- Identify the medicines to be restarted (see table below) and renew the orders by:
- Select the medication in the previous care episode
- Select the order modify tab
- Click ‘renew order’
- Double check that the route and schedule are appropriate.
Which Drugs Need to be Restarted?
- The renal nurses will likely tell you “Innohep, Diafer and Aranesp” but there may be variations / other medicines needed. Note that the default route for tinzaparin and Aranesp is SC but we give them to our dialysis patients IV via the dialysis machine.
- The following are common drugs used on dialysis patients (see table for route, dose and frequency)
* one patient with HIT is on Fondaparinux 2.5mg/session.
- Other drugs often prescribed for patients on the renal unit:
- PRN: Paracetamol, Oxycodone, Saline/Salbutamol nebs, GTN spray, peptac and anti-emetics.
- Regular: Pregabalin, Gabapentin, Alfacalcidol (rarely).