Pharmacology · single question
Drug of choice for pain management in a patient with RENAL DISEASE (kidney failure)?
Show answer and explanation
Correct answer: B. Acetaminophen — safer than NSAIDs in renal disease (first-line analgesic)
✓ B) Acetaminophen is the SAFER analgesic in renal disease.
Renal disease pain management: NSAIDs/ibuprofen CONTRAINDICATED — inhibit prostaglandin-mediated renal perfusion → worsening renal function, fluid retention, hyperkalemia. Acetaminophen: primarily hepatically metabolized (glucuronidation), renally excreted metabolites — use at reduced dose (≤2g/day) and avoid in severe renal failure (accumulation of metabolites). If opioids needed: hydromorphone or fentanyl preferred (metabolites less toxic than morphine/meperidine). Avoid codeine (active metabolite accumulation in renal failure → CNS toxicity).
Renal disease pain management: NSAIDs/ibuprofen CONTRAINDICATED — inhibit prostaglandin-mediated renal perfusion → worsening renal function, fluid retention, hyperkalemia. Acetaminophen: primarily hepatically metabolized (glucuronidation), renally excreted metabolites — use at reduced dose (≤2g/day) and avoid in severe renal failure (accumulation of metabolites). If opioids needed: hydromorphone or fentanyl preferred (metabolites less toxic than morphine/meperidine). Avoid codeine (active metabolite accumulation in renal failure → CNS toxicity).