Use of LAMA in Pt's who have AKI as a result of Covid
I'm a respiratory nurse in primary care.
I have just been reading the latest NICE guidance update issued today which pertains to AKI due to Covid.
I currently use the Cockcroft & Fault formula to calculate the creatinine clearance as much as possible but will use eGFR if I don't have all information to hand to do this.
At present I ensure all my patients under my care who are on a LAMA are on one which may not affect their eGFR - ie 45ml/min don't prescribe inhalers with Tiotropium, if eGFR is less than 30ml/min then won't prescribe Glycopyrronium.
Couple of questions:
Do you just use the eGFR or are you are using the Cockcroft & Fault formula to calculate correct creatinine clearance levels?
What advice would you suggest is given to GP's regards witholding/changing a pt's LAMA in light of AKI whilst Covid positive or post covid? Would this be the same as you would for example with the use of Metformin.
Thanks in advance