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Renal dosing — DGM MCQ

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ModeratePolypharmacyRenal dosingDGM

An 88-year-old woman with chronic kidney disease is prescribed a new medicine for neuropathic pain. She becomes drowsy and ataxic within a week. eGFR is 24 mL/min/1.73m2. Current medicines include gabapentin, ramipril and furosemide. What is the most appropriate assessment?

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Correct answer: E — Review renal dosing and adverse effects

Gabapentin requires renal dose consideration, and toxicity can cause drowsiness and ataxia. Rapid escalation worsens toxicity, Parkinson's disease is not the best acute explanation, vestibular surgery is irrelevant, and renal impairment should not be dismissed. Renal function should shape prescribing in frail older adults.

Reference: BNF; NICE NG56