In the context of renal impairment, what is the safest action regarding medications prescribed?

• A. Plan to administer lower doses of the medications due to the decreased ability of the kidneys to eliminate the drugs.
• B. Consider administering higher doses of the medications to promote more effective elimination of the drugs.
• C. Have his prescribed medications and doses reviewed by the prescriber and pharmacist prior to administering the drugs.
• D. Do not administer any medications that are known to be eliminated through the kidneys.

Answer: (C)

When kidney function is reduced, medication safety depends on having prescribed drugs and their doses reviewed by the prescriber and pharmacist before administration. This collaborative review ensures that each medication’s renal dosing needs are considered—adjusting dose or dosing interval based on the patient’s current renal function, monitoring for adverse effects, and selecting alternatives if needed. It prevents both unintended toxicity from accumulation and lack of therapeutic effect from underdosing, by tailoring decisions to the individual's labs and overall clinical picture. Simply lowering doses across the board or avoiding all medications that are renally eliminated isn’t appropriate, and increasing doses can raise the risk of toxicity; the safest path is a professional review to determine the correct plan for each drug.