Which of the following medications can be prescribed safely to patients with renal impairment ?
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Answer: D. Diazepam
Explanation
Diazepam is a benzodiazepine that undergoes extensive hepatic metabolism into active metabolites. Its elimination relies primarily on the liver rather than direct renal excretion pathways. Consequently, it can be prescribed safely to patients experiencing renal function impairment. Benzodiazepines enhance the effect of the inhibitory neurotransmitter GABA in the brain. Hepatic cytochrome P450 enzymes metabolize most lipophilic drugs into water-soluble compounds. Renal impairment requires careful dosage adjustments for drugs eliminated primarily by the kidneys.
Managing anxiety or seizures in kidney disease patients requires carefully selected medications. Diazepam provides reliable sedation and muscle relaxation without direct nephrotoxic risks. Hepatic function should still be monitored during prolonged benzodiazepine therapy courses. Phenacetin is an analgesic associated with significant nephrotoxicity and renal papillary necrosis. Tetracyclines can worsen uremia in renal impairment due to their catabolic metabolic effects. Aminoglycosides carry a high risk of nephrotoxicity and require strict dosage adjustments.
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