Nephrotoxic drugs: Difference between revisions

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Latest revision as of 16:16, 10 August 2012

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Aarti Narayan, M.B.B.S [3]

Overview

Nephrotoxic drugs are pharmacotherapies that can lead to a decline in renal function. The drug may need to be discontinued, or the dosing reduced when this happens.

Common Nephrotoxic drugs

Antibiotics

Antibacterials

Aminoglycosides (10-15% Incidence of acute tubular necrosis)

Occurs in 10-20% patients on 7 day course
Results in non-oligurics; increased creatinine
A single dose early in septic course is usually safe

Antivirals

Acyclovir (only nephrotoxic in intravenous form)
Adefovir
Cidofovir
Foscarnet
Indinavir
Tenofovir

Antiparasitic drugs

Chemotherapy and Immunosuppressants

Heavy Metals and Poisons

Arsenic poisoning
Bismuth
Gold therapy
Lead poisoning
Lithium related kidney disorders

Polydipsia and nephrogenic diabetes insipidus
Acute renal failure
- Dialysis indications: serum creatinine >2.5 or seizures, rhabdomyolysis
Chronic kidney disease with fibrosis

Mercury poisoning
Nitrosourea compounds

AntiHyperlipidemics

Fenofibrate (Tricor)

Increases serum creatinine without significant decrease in GFR
Serum creatinine rise is reversible on stopping fenofibrate

Gemfibrozil

Associated with acute renal failure due to rhabdomyolysis

Statins

Chemotherapy

Causes fanconi's syndrome

Lomustine

Proton channel blockers

Miscellaneous Drugs

Chronic stimulant laxative use

Resulting chronic volume depletion and hypokalemia causes nephropathy

Expect an increase of serum creatinine in chronic kidney disease

Low dose aspirin reduces renal function in elderly
- Decreased creatinine clearance after 2 weeks of use
- Changes persisted for at least 3 weeks off aspirin

Aristocholic acid containing Chinese herbals
Bevacizumab
Carbon tetrachloride
Cimetidine
Ciprofloxacin
Clopidogrel
Dilantin
Diuretics

Infliximab
Interferons
Mesalamine (Asacol, Pentasa)

Mesalamine is an NSAID analog and has systemic absorption from the bowel

NSAIDs: celecoxib, ibuprofen, naproxen

Nephrotic syndrome type reaction

Hypersensitivity (fever, rash, arthralgia)

Vasculitis reaction

Drugs of abuse

Nephrotoxic Drugs in Alphabetical Order

ACE Inhibitors
Acetaminophen
Acyclovir
Adefovir
Allopurinol
Aminoglycosides
Amitriptyline
Amphotericin B
Angiotensin converting enzyme inhibitors
Anticoagulants
Aristocholic acid containing Chinese herbals
Arsenic poisoning
Aspirin
Bevacizumab
Bismuth
Carbon tetrachloride
Carboplatin
Carmustine
Celecoxib
Cephalosporins
Chloroquine
Cidofovir
Cimetidine
Ciprofloxacin
Cisplatin
Clopidogrel
Cocaine
Cyclosporine
Dilantin
Diphenhydramine
Diuretics
Doxepin
Doxylamine
Erythromycin
Esomeprazole
Fenofibrate (Tricor)
Fluoxetine
Foscarnet
Furosemide
Gemfibrozil
Gentamycin
Gold therapy
H1 antagonist
Heroin
Hydroxychloroquine

References

Template:WikiDoc Sources

@@ Line 1: / Line 1: @@
+__NOTOC__
 {{SI}}
-{{CMG}}
+{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}, {{AN}}
-__NOTOC__
-'''Associate Editor-In-Chief:''' {{CZ}}
+==Overview==
+Nephrotoxic drugs are pharmacotherapies that can lead to a decline in renal function.  The drug may need to be discontinued, or the dosing reduced when this happens.
-{{Editor Help}}
+==Common Nephrotoxic drugs==
+*[[Acetaminophen]]
+*[[Aspirin]]
+*[[H1 antagonist]]
+*[[Cephalosporins]]
+*[[Cocaine]]
+*[[Diuretics]]
+*[[NSAID]]s
+*[[Penicillin]]s
+*[[Proton pump inhibitors]]
+*[[Angiotensin converting enzyme inhibitor]]s
+*[[Statins]]
 ==Antibiotics==
-*[[Aminoglycosides]] (10-15% Incidence of Acute Tubular Necrosis)
+===Antibacterials===
-:* Occurs in 10-20% patients on 7 day course
+*[[Aminoglycosides]] (10-15% Incidence of [[acute tubular necrosis]])
-:* Results in non-oligurics; increased [[Creatinine]]
+:*Occurs in 10-20% patients on 7 day course
-:* A single dose early in septic course is usually safe
+:*Results in non-oligurics; increased [[creatinine]]
-* [[Sulfonamides]]
+:*A single dose early in septic course is usually safe
-* [[Amphotericin B]] (Incidence 80-90%)
+*[[Amphotericin B]] (Incidence 80-90%)
-* [[Levofloxacin]]
+*[[Ciprofloxacin]]
-* [[Ciprofloxacin]]
+*[[Chloroquine]]
-* [[Rifampin]]
+*[[Erythromycin]]
-* [[Tetracycline]]
+*[[Gentamycin]]
-* [[Acyclovir]] (only nephrotoxic in intravenous form)
+*[[Hydroxychloroquine]]
-* [[Pentamidine]]
+*[[Isoniazide]]
+*[[Levofloxacin]]
+*[[Methicillin]]
+*[[Rifampin]]
+*[[Sulfonamides]]
+*[[Tetracycline]]
+*[[Trimethadione]]
+*[[Vancomycin]]
+===Antivirals===
+*[[Acyclovir]] (only nephrotoxic in intravenous form)
+*[[Adefovir]]
+*[[Cidofovir]]
+*[[Foscarnet]]
+*[[Indinavir]]
+*[[Tenofovir]]
+===Antiparasitic drugs===
+*[[Chloroquine]]
+*[[Hydroxychloroquine]]
+*[[Pentamidine]]
+*[[Quinine]]
 ==Chemotherapy and Immunosuppressants==
-* [[Cisplatin]]
+*[[Cisplatin]]
-* [[Methotrexate]]
+*[[Cyclosporine]]
-* [[Mitomycin]]
+*[[Interferon alpha]]
-* [[Cyclosporine]]
+*[[Methotrexate]]
+*[[Mitomycin]]
+*[[Foscarnet]]
+*[[Tacrolimus]]
-== Heavy Metals==
+== Heavy Metals and Poisons==
-* [[Mercury]] Poisoning
+*[[Arsenic]] poisoning
-* [[Lead]] Poisoning
+*[[Bismuth]]
-* [[Arsenic]] Poisoning
+*Gold therapy
-* [[Bismuth]]
+*[[Lead]] poisoning
-* [[Lithium]] related kidney disorders
+*[[Lithium]] related kidney disorders
-:* [[Polydipsia]] and [[Nephrogenic Diabetes Insipidus]]
+:*[[Polydipsia]] and [[nephrogenic diabetes insipidus]]
-:* [[Acute Renal Failure]]
+:*[[Acute renal failure]]
-:*:* [[Dialysis]] indications: [[Creatinine]] >2.5 or [[Seizure]]s, ALOC, [[Rhabdomyolysis]]
+:*:*[[Dialysis]] indications: [[serum creatinine]] >2.5 or [[seizure]]s, [[rhabdomyolysis]]
-:* [[Chronic kidney disease]] with [[fibrosis]]
+:*[[Chronic kidney disease]] with [[fibrosis]]
+*[[Mercury]] poisoning
+*[[Nitrosourea compounds]]
 ==AntiHyperlipidemics==
+*[[Fenofibrate]] (Tricor)
-* [[Statin]]s
+:*Increases [[serum creatinine]] without significant decrease in [[GFR]]
-* [[Gemfibrozil]]
+:*[[Serum creatinine]] rise is reversible on stopping [[fenofibrate]]
-:* Associated with [[Acute Renal Failure]] due to [[Rhabdomyolysis]]
+*[[Gemfibrozil]]
-* [[Fenofibrate]] (Tricor)
+:*Associated with [[acute renal failure]] due to [[rhabdomyolysis]]
-:* Increases Serum [[Creatinine]] without significant decrease in [[GFR]]
+*[[Statin]]s
-:* Serum [[Creatinine]] rise is reversible on stopping [[Fenofibrate]]
 ==Chemotherapy==
+*[[Carmustine]]
+*[[Carboplatin]]
+*[[Cisplatin]]
+*[[Ifosfamide]]
+:* Causes [[fanconi's syndrome]]
+*[[Lomustine]]
-* [[Cisplatin]]
+==Proton channel blockers==
-* Ifosphamide
+*[[Esomeprazole]]
-:* Causes [[Fanconi's Syndrome]]
+*[[Lansoprazole]]
+*[[Omeprazole]]
+*[[Pantoprazole]]
+*[[Rabeprazole]]
 ==Miscellaneous Drugs==
+* Chronic stimulant [[laxative]] use
+:* Resulting chronic volume depletion and [[hypokalemia]] causes [[nephropathy]]
+* [[Radiocontrast agents]]
+* [[ACE Inhibitor]]s
+:* Expect an increase of [[serum creatinine]] in [[chronic kidney disease]]
+*[[Acetaminophen]]
+*[[Amitriptyline]]
+*[[Anticoagulants]]
+*[[Allopurinol]]
+*[[Aspirin]]
+:* Low dose [[aspirin]] reduces [[renal function]] in elderly
+:*:* Decreased [[creatinine clearance]] after 2 weeks of use
+:*:* Changes persisted for at least 3 weeks off [[aspirin]]
+*Aristocholic acid containing Chinese herbals
+*[[Bevacizumab]]
+*[[Carbon tetrachloride]]
+*[[Cimetidine]]
+*[[Ciprofloxacin]]
+*[[Clopidogrel]]
+*[[Dilantin]]
+*[[Diuretic]]s
+:*[[Thiazide]]s
+:*[[Furosemide]]
+:*[[Triamterene]]
+*[[Doxepin]]
+*[[Fluoxetine]]
+*[[H1 antagonist]]s
+:*[[Diphenhydramine]]
+:*[[Doxylamine]]
+*[[Infliximab]]
+*[[Interferon]]s
+*[[Mesalamine]] (Asacol, Pentasa)
+:*[[Mesalamine]] is an [[NSAID]] analog and has systemic absorption from the bowel
+*[[NSAID]]s: [[celecoxib]], [[ibuprofen]], [[naproxen]]
+:*[[Nephrotic syndrome]] type reaction
+*[[Penicillin]]s and [[cephalosporin]]s
+*[[Pamidronate]]
+*[[Propylthiouracil]]
+:*[[Hypersensitivity]] ([[fever]], [[rash]], [[arthralgia]])
+*[[Rifampin]]
+*[[Sulfonamide]]s
+:*[[Vasculitis]] reaction
+*[[Ticlopidine]]
+*[[Zoledronate]]
-* Chronic Stimulant [[Laxative]] use
+==Drugs of abuse==
-:* Resulting chronic volume depletion and [[Hypokalemia]] causes [[nephropathy]]
+*[[Cocaine]]
-* Radiographic contrast
+*[[Heroin]]
+*[[Ketamine]]
+*[[Methadone]]
+*[[Methamphetamine]]
+==Nephrotoxic Drugs in Alphabetical Order==
+{{MultiCol}}
 * [[ACE Inhibitor]]s
-:* Expect an increase of Serum [[Creatinine]] in [[Chronic kidney disease]]
+* [[Acetaminophen]]
-* [[NSAID]]s
+* [[Acyclovir]]
+* [[Adefovir]]
+* [[Allopurinol]]
+* [[Aminoglycosides]]
+* [[Amitriptyline]]
+* [[Amphotericin B]]
+* [[Angiotensin converting enzyme inhibitor]]s
+* [[Anticoagulants]]
+* [[Aristocholic acid containing Chinese herbals]]
+* [[Arsenic]] poisoning
 * [[Aspirin]]
-:* Low dose [[Aspirin]] reduces [[Renal function]] in elderly
+* [[Bevacizumab]]
-:*:* Decreased [[Creatinine Clearance]] after 2 weeks of use
+* [[Bismuth]]
-:*:* Changes persisted for at least 3 weeks off [[Aspirin]]
+* [[Carbon tetrachloride]]
+* [[Carboplatin]]
+* [[Carmustine]]
+* [[Celecoxib]]
+* [[Cephalosporins]]
+* [[Chloroquine]]
+* [[Cidofovir]]
+* [[Cimetidine]]
+* [[Ciprofloxacin]]
+* [[Cisplatin]]
+* [[Clopidogrel]]
+* [[Cocaine]]
+* [[Cyclosporine]]
+* [[Dilantin]]
+* [[Diphenhydramine]]
+* [[Diuretics]]
+* [[Doxepin]]
+* [[Doxylamine]]
+* [[Erythromycin]]
+* [[Esomeprazole]]
+* [[Fenofibrate]] (Tricor)
+* [[Fluoxetine]]
+* [[Foscarnet]]
+* [[Furosemide]]
+* [[Gemfibrozil]]
+* [[Gentamycin]]
+* [[Gold]] therapy
+* [[H1 antagonist]]
+* [[Heroin]]
+* [[Hydroxychloroquine]]
+{{ColBreak}}
+* [[Ibuprofen]]
+* [[Ifosfamide]]
+* [[Indinavir]]
+* [[Infliximab]]
+* [[Interferon alpha]]
+* [[Interferon]]s
+* [[Isoniazide]]
+* [[Ketamine]]
+* [[Lansoprazole]]
+* [[Laxative]] use
+* [[Lead]] poisoning
+* [[Levofloxacin]]
+* [[Lithium]]
+* [[Lomustine]]
+* [[Mercury]] poisoning
 * [[Mesalamine]] (Asacol, Pentasa)
-:*:* [[Mesalamine]] is an [[NSAID]] analog and has systemic absorption from the bowel
+* [[Methadone]]
-* [[Penicillin]]s and [[Cephalosporin]]s
+* [[Methamphetamine]]
-:* [[Hypersensitivity]] ([[fever]], [[rash]], [[arthralgia]])
+* [[Methicillin]]
-* [[Sulfonamide]]s
+* [[Methotrexate]]
-:* [[Vasculitis]] reaction
+* [[Mitomycin]]
+* [[Naproxen]]
+* [[Nitrosourea compounds]]
 * [[NSAID]]s
-:* [[Nephrotic Syndrome]] type reaction
+* [[Omeprazole]]
+* [[Pamidronate]]
+* [[Pantoprazole]]
+* [[Penicillin]]s
+* [[Pentamidine]]
+* [[Propylthiouracil]]
+* [[Proton pump inhibitors]]
+* [[Quinine]]
+* [[Rabeprazole]]
+* [[Radiocontrast agents]]
 * [[Rifampin]]
-* [[Diuretic]]s ([[Thiazide]]s and [[furosemide]])
+* [[Statins]]
-* [[Allopurinol]]
+* [[Sulfonamides]]
-* [[Cimetidine]]
+* [[Tacrolimus]]
-* [[Ciprofloxacin]]
+* [[Tenofovir]]
-* [[Dilantin]]
+* [[Tetracycline]]
+* [[Thiazide]]s
+* [[Ticlopidine]]
+* [[Triamterene]]
+* [[Trimethadione]]
+* [[Vancomycin]]
+* [[Zoledronate]]
+{{EndMultiCol}}
-==Drugs of abuse==
+==References==
-* [[Cocaine]]
+{{reflist|2}}
 [[Category:Drugs]]
 [[Category:Nephrology]]
-{{SIB}}
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 {{WikiDoc Sources}}

Nephrotoxic drugs: Difference between revisions

Latest revision as of 16:16, 10 August 2012

Overview

Common Nephrotoxic drugs

Antibiotics

Antibacterials

Antivirals

Antiparasitic drugs

Chemotherapy and Immunosuppressants

Heavy Metals and Poisons

AntiHyperlipidemics

Chemotherapy

Proton channel blockers

Miscellaneous Drugs

Drugs of abuse

Nephrotoxic Drugs in Alphabetical Order

References

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