Multiple Dose Elimination Kinetics and Drug Accumulation in Patients with Normal and with Impaired Kidney Function

Toxic drug accumulation is a serious problem in pharmacotherapeutics. A theory of drug accumulation which can be used by the practising physician is therefore urgently needed. Such a theory not only should be correct in the formal sense and quantitatively solve the specific dosage problems of practical pharmacotherapeutics; in addition it should be formulated in such a way that it can be readily understood by the clinician. Based on the work of Dost and Kriiger- Thiemer on multiple dose ehmination kinetics the author outlines a theory of drug accumulation which is adapted to the mathematical background of the clinician. The calculation of “individualized” dosage schedules for patients with impaired kidney function is shown as a practical example.