Anitoitico 089A. wévooo [roo Sonera] 59-30 mm T “som summer nt oss ve ‘ARTIBISTIEOS “resides — eho) oy Sai Sarah ees serine Carbovenem rece Tie Teena | oe 0 om ae Tao Cefalesporingt ‘ease n/m ins | sam miniionenieme chelation eeatene ar: | conan | snc siceransemynen | gunmen nceraas mn empresasTeabece | SOss FR NORMAL [wrobe[foo-soimin | _So- ior “nin Tenens Sane Taerehoior Cprtomsee [S00 TSoeaTED a am a EERSTE Leveonao 250-750me28h 0 [toon eerenty momen aso: oorent yer] noibpeaaie eis oma a oo 700% pater eroxia ~woreyizn [eae Tas star co Ta sDing TE “D0 dong Dingoes | ToS pT Tr —— oo oan | SERED woarran se froma EA] oss - - mg/s2 24h 250 mg/i2 24h —— Tonite [50 Smee TR Wa] 9 [soo 100% 37 35 Milne once nsec 0 S0Oge-an | =] ae im it FT cere 175-1 ge | 05 ‘oni 5008 i TE WTaa dO cotnins [2 ointlomsaeunie-sar| | vamuvetmn| «5-75 muvze asmean cir= 100-30 in “ ne “ MAW 26h post (alas HO) atens seman: 7 — sg 28 semana. 375 mg2¢_] 375mg 2tsemena_| semana. Nodoss extra Teor Tima [ome cia eis Cae pon iar samgesth [ioe rr Caen ti pestis —[ CaSO etre tts oie Tar fae Setanta tga i |“ Ginser Geath Tas ape ree Teh 1 | tates Gao Gee Tair Tae oa “itn soome/t2h ee ee Soivpeataie | _ certo mlnin Vancomicina sith Del Lphzh 924-96 4-6 ding | CARO eN/rnin. Si membre | 509 rag/24- 20h i500 me postin"ACLARAMIENTO DE CREATININA Antibiético DOSISF.R. NORMAL | _MéTODO | 100-SOmi/min | 50-10 ml/min <10mi/min | Suplemento HD Dosis HFVVC Rati Timah vivoanes: | PENS | woom | cates 12h | cotazen [oss posse Fi/dwin | _so/125 ma/ah | bet | Sooi0s ma/a | 507105 ma eh [250/25 ah Done vost Aplin Bongaveh [1 too [eee t2h | Goh —[ooss ponins — 28/6 ° soo | segurcons00 | sgutcon sn | €2250mE meie-eh | mgle-12n Penis [oS wea] —D i TE 70S [Boe ei | Ganda Pearce seaga-oh [1 io [tang 10] eat th —[ 0s petite | er0-10 min Piperacilina / 2.25 g/6 h; sIFG< Extra 0.75 ‘Tazobactan Sais “aee lab ea ia 20 mi": 2.25 g/8h 225 postdidlisis Tiron wan ber | tawah | i-geh | age a TT Tex sagan | oer | atean | atye-1m | 2oeszn | aureagpona Tarde ovina Toonghah [ne | 0m Ta To te Tevecins [ 30-00mg/6-H [1 100% | Gotara-2eh | tozeh Woambience oss HORNA sutrooo | iG6-somime | 50-10ra/min omnia | _ supine ro ove He ‘mmrnecos notre ‘Sralalath [Sawa anal ES awa 1% 0-0 Vn ‘een 50-70 naa Ne 8 10% 0 io vom oo adele se orem] —O 008 Boon aT Boomaieah | S00 oi ona | CTE ona Sars eghgleh 1 | eat Tato a8h ane aah | Dovepontiien | ans irene, 100-200 gl 2 0% 100% | 10 ds recomend mona 200g 00 | We rs er prea cel ea ne her. vorconaet0, anaes " 98 109% 80% | ano ovement er ee ee RTARASTOS Dertaris Tae 7 Gane Ta = eanaeiia raat aa = = = coos | Hit dae eames Coins 2 m4 onesie ‘nie omy 7 sh sae Tae Dost ais SDD ile TUMREULOICOE ‘edn _—— =| a om [roonsicceeaomumin pcan | recnucn recast ne anes x si mi 0 0 Bait soca = 2 oe sta esomneaa | ee a ‘Batol ERneleiehwen teen | —_o “0% 100% Een Taree | Fein ‘ova Sa0- 1s rg) D so 100% 08 te ena 509/24 Ne Fo 1008 1008 Bossa Presence 35 mangtn wonigtey [6 0% Biinpigian ——_|s220ne//i| or oo S00 4/24 We 0 Taw oKcKr sonny | om Deseo Tiersen oar a cy 10% Senge co ‘ssentne Sing teens Me a oon ven | 1 de recomend tne 0 y/enanemanna TSS powo ween [seh ea mine Das lea Song Der = omg Tiga Tagg Benga co Begs n ath rege an os sene/anth == nei ber (earn | Aimee yeeir om women | an mea un coma Frese ern >) Saetaem ee _ cn a aa Sa = a a ma Saaaiae = Taira 2 Tepurene aang Dies Sr Tousazh Eewhsz AN Bas Anh, aren canis Carta smahgitehvs pet | assmpigztn aorsanghent casgacen | Seishin fenel asi pane 051 goenw nas a ber ia ong a a eran angen com onrgrin [we om a = fee Saas ern rah > 100% 1H c-atmn ah ier step Se = = co ae ie Prcwwarceaaaesio| enscrmcromgr 2 1m sonnet evr eer foseno aan “ frets aang ee > vw {ao 88 <0 man ve er en et Daas rm iam maw ra TraTA ‘Dose ER WoRMal—[-wiTopO | —168-So mime Sara Ziorijem | Siplenereno [Dearne forties 2S Ne 10% oo 100% | Dos eats Nomina a Fmgiahsce< | adwgiith Seta allan zacey | tase w! ain S0mg/32h Sonya a nse Partrene Timer rs 100% So Toe | Voss pone bavi 300 suo eth 0 _[ S00 mah aw ra nee [emai artdina soomg/i2» 2000/12» soo ng/2h a00mg/208 | 100/24 [reer Ogi D 00% TOR Se 0 Ea Eee iu eos 00 mala ° 0% 0a CC 30m: ar Eater Bae stowed 2osme/s2h bel 1008 20 mg/h Domal2dn | Dose ponaatae [Cart0s0 mim 1 [omen Sead et aOORE| fener suomgiath s00mgr24 fesjcor apna tar ‘ar [vaeconr ia Del ait O5-19)1224h Osgeeh | Deseo Tooraan Soe] Umea Bora |vseercdour urea bet : f wsarsCeciOeifn] Sitar comin esang/25 soe com Tange = 0% TES Sere st m/e Ea Ta steabins O75 re/th ery Cie 128 Gece 2th | Was estas [Cerio SO aU Gimahayan semanas Te como mime paseo preva] = Ronin S20 neherta] — oe seh ery 7a6ee Tasos saan edu Ziman | awa Breit Wowie | win | awlian ‘Manterimenis —[izoma/anhil 9oma/2eh wome/ath Gosngteh | —wimg/asn | ooma/aa [RctesaaeRina | 50/2508 2h 2 30 00% Precucco enter Eta fame otioongieth | 0 10000% C0004 enter a ee 00/100/100 a 28 : z fener tena 25mai2mn ° zsmei2ah Bemeatn SGercis minin We | worecomendato, | 28me/zah"ACLARAMIENTO DE CREATININA. ANTINFIAMATORIOS _[DOSIS FR: NORMAL| METODO_| 100-S0mi/min | 50-20 mi/min | <20mi/min | Suplemento HD 75-50%. Etar catecoxb 200 mg/24h > 10075% | conrc<30 | evar evitar cole [lonbine Lsina Beas0melesh | 0 Too 75-50% iter iter Dexketoprofeno 1255-25 mg/ah D 300-75% 75-50% Evitar Evitar Diclotenaco 50 mg/a-12h 3 100% 75 50% Eitan Evitar Etoricoxib 20-60 mg/24h D 100% Eeengarie $30) evttar evitar urbiprofeno 875 ma/6h D 700% 100% tar fvitar Ibuprofen 600 me/6-8h dD 100% 75-50% Evitar Evitar indometacina 75-50mg/8-12h]| 00% 50%. Evitar evitar [ketoprofeno SOma/a-2h > 70085 75-50% fvitar fvitar 75-50%, Eultar aproxeno ssome/iz-2ah | 0 10-75% | conro<30 | —evitar cvitar ene Parecoxib (inyeccién iv o Im) 40 mg /24h D 100% 75-50% 50% 50% Piroxicam D 200% 75.50% Fvitar Fvltar sulindac D 200% 100-759 50% 50%[ante YORE Peay Mine [eon coma cone [Rae Tome dersxomend| 0 | HOH 1008 cos | 100 aomenini neon) |» | a0 r= 2 2 ae a ry =a | ae ro-mo msn 0 | tom | eo csomIIN Koen | oon Tama — >| mm 1 wm | todas Cs des masenma er a oe oars arts spa aimed tng? oh a so iar ms eam! anwosh >| a0 20 | eeu co an ate > |e - om | te ae Iniciar con <50% de dosis y ttuk oncsora ae D neon se Paver Os tg sh Ceiwe tn] wonaloh | sooner | Wo fra oi neiesh fe 1a a a a a a aT = O05 rth t e505 eis cath cals eet Tonge ar cat ee = eae a rs = = a 15-6 my/24 ° sons —— No retomendado ‘Na recomendado 7 on lereapne aorta | sanevn 5 = oo om oI ee =] ane = = ron tinwtiiened _| 6 Sai Te a eda eras 1ago30-aongen | = ne Setanta vorrei ame a 7 = i Tomi ise [itio, carbenato, one o 100% 75-50% ‘90.25% (Control litem estacto). | Dosts postetiists = aa aimee 2 caer en ae ma oe = [emer tm . ie i eo ‘oan = aoa ; | a | aenewre [aT eee [esa esi 75a 7 75 smh a aT com aaa z a i ia ae marae : = care ara Zam a w-stoneit-t2y | 0 | wowacer 3006 100% 300% 00% indepamids 125-5 mg/2ah 0 300% Tian cre uit Evkar Metaiazona 2370 mya i 300% 100% 1 10 Tesi 25-50 mg24n 0 109% 100% tar liar Tolvanten 15 130mg/24h o 100% boss. Na Eater oe Toresemida 7.510 ma/24h o 100% 100% 100% os Tiamterene| 50-160 mg/24h > 300% 30096 itr Estar Betablogsnantes ‘Atenolt 5100 mg/h o 70008 500 75 Dass oat Bisopro1 0 mw/24h, 0 300% 7596 50% Hloditos Carved: Tso mg/d 0 10016 10098 00% os Catproot 20-400 me/24h o 100% 7s. Ear ae Labetall 100-200 mg/h o 100% 100% 100% on Metoprolol 7o9-200mg/P4h (1 tomas | 0. 100% 100% 100% Dosis pos da Nedotoh 40-80 mga o 300% 50% 25% 2536 Propranoiah 0mg/8- 12h, D 30016 75-50% 50% 5006 ‘Alfa 1 Bloqueantes Doxazosina TBA D 100% 1008 100% 00 Proves 110mg/4h o 100% 100% 100% ro Terazosina 2 5mg/2ah 0 200% 200% 00% 20055 Pee anata aa Urapial 25 mg V deinigo To Tico Lisox Lion Liov BitiedTenergieas camraies Gonna 05-12 maldia(2-ttomanl [9 100% 759% 50% 30% ‘Motildapa 259 1ec0my/i2h i Cada 17h Coda Cade 20h Dosis poss Moxonidina (02-0,.6ma/eia(2 tonsa) [0 (02-2. mada (tomasl [02-04 ma/2ah | 02 mal24h O2ma/24nTaRTHTA—[_—__DosSWoRMAE—wTonO 70-so Soo Som So Titres os RECAVARAT Beano aaa 5 cy Te SoBe Soa ‘ances Tanga . 100%, 10%, i st atop sng . “to 7 st Desseer aes Eos weet gh . Fo Bonga auth cones Fosnope Tonge 2 200%. 00%, 7 75-100 bear song 2 a0 om 70% Terni 7s sop 2g 5 ES Tes ata Taya DesspeROUS Tern BS Eorgiiah 5 Ema “om “to ito Sines amg | ia SS ale RE Bann eae ras ie Penden Smga . Smet Tag 2sh 5 cr 30min cafes | Teme Das cose ‘aur Toomer o 00%, 75-1008 78 Dassen anip SciOmgiah . 00% TE SoSH Deseo Sac Vrs] aa 0g o 00%, engi xa a Tens Sangin 3 08 Sng Brae ong Tendo 05 ingle 5 35-27 Tenis as Es rwaah Bsmeah Vosodaras Baroto Tigi se B 700% om ior ae sabe mismo TT uch en Ssh sish inopsis Us 1smgyg/nn neal 5 2005 1 eae ar ‘ato rigor Toso. Sage, 2 70m om Tio Tom serine Guoneih o 200%, Toner Ease Ear ase Boag 2 200%. 00% Ena co ano aauome 2 0% 0m 10% 005 acho. 3 amg/th 3 005 00% 100% 1008, carp ssarg/h = 200% oO Nar 10m evi ar Mani Seorgh 3 0% 75-50% ae Ease socomg2th 5 a 10%, co 10 vendiin aoaompsth 5 a 95, Sasa Sgt Vepamie Boast ng 2 200%. 0% 7 50[ACLARAMIENTO DE CREATININA CARDIOVASCULARES DOSIS F.R. NORMAL ‘méTopo | 100-SOmi/min [50-10 mi/min £10 ml/min ‘Suplemento HD_ eroneat 25-08 mep/eg/mn a 1008 100% 100% 1008 100 400 (2 on). priodsone na ° 100% 100% 100% 100% Beran 5 ng/ia 5 ioe i 100% io goa 025-075 mg/2ah Bi 100% [720 6h Biome Man | TSO a Dinerato de bors SmglS—4 0 108 00% 700% 100% cpt 100 me/oh 1 io ma/sh | edie 8-39h | Boman | — 100 ehh Bobanina 25-10 me/gin D 100% 100% 100% 1008 a S20 re/ighnin 2 1008 100% 100% 100% Soran cia 100-200ma/ D 100% ceo | somertan | some/tan oasis 300 SDOmBHIAR Dom :00%8 ee abrdinn 5-75 mg/12-2ah 008 100% Pecuetin | _Preaetn Milrinona Sena lleeh spd D 100% 0,4 - 0,3 meg/kg/min| 0,2 meg/ke/min | 0,2 mcg/ke/min gg/nin Manono de wnt | 30-40 gf -49% @ 1m 7m 70% io a |transdérmicos (retirada nocturna) ° 200% 2008 200% 200% foarte 03-4mam D 100% 100% 100% 100% opera 150-200ma7eh D 1008 100% 100% Fr‘Bose Feral etedo | 100-0mijram] s030mi/mim | 30-15 m/min asmymn HeMaD AUS ‘Anticooguvantes Precavein Valorerresga] Precaeln,Valorarieiga Alustar dos 21NR.2-3, star desis | Auster dosis aN | Austar dost ain] Jaenecumarat | Nisa oss INES . cae sy sy womaénicovsnesgo | tromsnco vs nesgo erotica ean [apa Sug/izh 2 Sagan | sagan [aang rata tar etierttn 50mg | asomgrtan | _180mg/24h itor kor itor Edonabin omg/3ah 2 come/san | s0melath | sOma/2Ah Botan Bitar Ribarcnable Tomes 5 aome/7ah | 1smeeizeh | ts me/20h tar ater Alusar dosis 3 INR 2-3 Precaueiin.Valorarresen| Precaulén. Valera esea watering compriidosde1,3.3y20 | 0 Autor dodeaInR Auster devs INR] vompoapususgo | trombéuco vs nego me hemaredeno hemocdicn ‘aaa 20 mictogramos/e, seid eangrelor depertusén vce 4 100% 100% 100% 00% 100% eiecencvictan:lees “epee ‘eae Trae Sorat Se iTafa Iiesoers = seat sine eet Bisa = = east ehberade Sabena aoant PE Labatinee meio aaa Sek 0-300 neh 5 1p ner aorlan Saas son “uo 100% ries iaaanoak ena SS soaonymin | 2050 ymin omy recodns 7 2 3% dae mows ned reeiiensns 2 2 ness noes ned sna 2 3 1 = 2s io aseneint > 1008 100% 1005 Terao ober Hig sneras ene SSE com com com co =a Taealedeetyisancaasica7 | = ceoe | 2 aed cess | Sagal seaanae | Tamale ear [csnom eens | 5 108 oe ie er tn [eee szyan = Too. ct 2 = es = sow 2 = soe oe a mi fs one 2 os oe Teer Tea eda [ecoscrs saan 2 . 730 son = 1 [sate atongintoa x5dae ry 00-758 soe sm er ie [erste Os areas 2 2 Tso so a Terzeonesle [cstie eu sgide 2 2 7 7 ae 8 [seine sonun" ° 1008 100% ie Baors Le = | ea es "ate ieee Seay Sa = = ea fas ey = = is me eases oo ote c = = = ipa we = i = = aoe ec = ra a ma age aE STS se me a mane 2 ee | vanetee | eeetlan cope naa Sr = ae wm cre ae = a Base Tas Sa — —— c = = fee == = = =ors Le = | ea es "ate ieee Seay Sa = = ea fas ey = = is me eases oo ote c = = = ipa we = i = = aoe ec = ra a ma age aE STS se me a mane 2 ee | vanetee | eeetlan cope naa Sr = ae wm cre ae = a Base Tas Sa — —— c = = fee == = = =ANTIRREUMATICOS DOSIS F.R. NORMAL METODO | 100-50 ml/min | 50-10 ml/min | <10 ml/min | HEMODIALISIS ‘Adalimumab 40 mg /15 dias D 100% Evitar Evian Evitar Alopurinol 300 mg /24h D 7586, 50% 259% 25% Colchicine 05-2 me/dta D 100% some EMers | evita eviter €er-<30 mi/min Etamecept 50 mg/semanal D 100% 100% 10% 100% Hidronlloroquina 200400 mg/2ah D 300% 75-50% 5096 50% Leflunomida 10 = 100 my/24h D Evitar Evitar Fvitar Estar Peniellamina 300 = 1000 ma/ 24h D 100% Evitar Evitar Evitar Probenecid 250 -500 ma/i2h D 100% Evitar bvitar tvitar Sulfasalazine T-2y/24h (4 tomas) D Evitar Evitar Evitar Evitarpicestivo | bosisr.R. NORMAL | METODO | 100-SOmI/min | S0-10mi/min | <10ml/min | _HEMODIALISIS Acido obeti 5 me/2ah oD Precaucion Precaucion Precaucién Precaucion Algeldrato 310-620 mg/oh D 100% 100% Evitar Evitar ‘Almagato ie/ah D 100% 100 - 759% Evitar Evitar Bezlotoxumab 1Ome/kg D 100% 100% 100% 100% Domperidona 10 mg/8h i Cada 8h Cada 12- 24h Cada 24h Cada 24h Esomeprazol 20-40 mg /24h D 100% 100% 100% 100% Famotidina 20-40 mg /24h D 50% 25% 10% 10% Lansoprazol 15-60 mg D 100% 100% 100% 100% Metoclopramida | 10-15 mg/ 8h D 100% 75% 50% 50% isoprostol 200 my/6 = 8h oD 100% 75-50% 50% 50% Naloxegol 25 mg/24h D 100% 50% 50% 50% Nizatidina 300 me/24h D 100- 75% 50% 259% 259% ‘Omeprazol 20-60 mg D 100% 100% 100% 100% Ondansetron. 8-32 ma/dia D 100% 100% 10086 100% Pantoprazol 40 ma/2ah D 100% 100% 00% 100% Rabeprazol 10-20 mg/2ah D 100% 100% 100% 100% Renitidina 1150-300 mg /24h D 759% 50% 259% 259% Sulfasalazina| 1-2.g/24h (2-3 D Precaucion Evian Evitar EvitaraR To IR — | ETO So a ae CNS = soma Bawa este Reute licshon Sirpnin peB B oe 0% “eos jonas Tee o Try Larwoa om Ere oven Espa 2 oe 258 a ear =< Sree 2 os Tre Gntandaios Or ae Tresrace Cavanacan Jsoinst See 2 ox om wie Noda musasiones0oog 2 desea ome arena Tea Tea Tea mera vane saci 7 toy | EE PSRERccontnnFSG | PHT sOnMn ORG | ROI ni pS rates [gnineeemarmna| 1 1 i erences enc vadet ewan 2 “ome ms ae a ery anwinae = i = roo Teneo 0 ae Tsao gO ir Ene sts Tray 2 ek a ‘a ‘a0