The role of the suspicious renal pharmacist in identifying unusual adverse drug reactions-why this is not a small problem.

Renal patients have a high incidence of adverse drug reactions due to both pharmacokinetic and pharmacodynamic changes and detecting these adverse drug reactions relies heavily on having a high index of suspicion-which seems to be invoked through experience, whether our own or that of our colleagues. Pharmacists must be vigilant about adverse drug reactions and it is vital that pharmacists continue to teach their colleagues about their experiences identifying less common adverse drug reactions and adverse drug reactions with unusual presentations in addition to simply reporting these adverse drug reactions.