Ace the Certified Nephrology Nurse 2025 Exam – Dive into Dialysis Mastery!

The medication that is typically cleared by hemodialysis is tobramycin. This aminoglycoside antibiotic is highly water-soluble and has a low volume of distribution, making it effectively removed from the body during the hemodialysis process. Hemodialysis is particularly useful for drugs that are primarily eliminated via the kidneys or that have a low protein binding capacity, which allows for more efficient removal during dialysis sessions.

Other options, such as digoxin, enalapril, and prednisone, have different pharmacokinetic properties. Digoxin is primarily cleared through renal excretion but is also highly protein-bound and may not be significantly removed by dialysis. Enalapril is an ACE inhibitor that is partially cleared by the kidneys, and its active metabolite, enalaprilat, can also be removed, although it doesn't clear as effectively as tobramycin. Prednisone, a corticosteroid, is mainly metabolized in the liver and is not significantly cleared by hemodialysis due to its extensive protein binding and liver metabolism.

In the context of managing patients with renal impairment, understanding the clearance characteristics of various medications helps clinicians make informed decisions about medication management and the necessity for adjustments or alternative therapies.