Nephrotoxic drugs

WikiDoc Resources for Nephrotoxic drugs
Articles
Most recent articles on Nephrotoxic drugs Most cited articles on Nephrotoxic drugs Review articles on Nephrotoxic drugs Articles on Nephrotoxic drugs in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Nephrotoxic drugs Images of Nephrotoxic drugs Photos of Nephrotoxic drugs Podcasts & MP3s on Nephrotoxic drugs Videos on Nephrotoxic drugs
Evidence Based Medicine
Cochrane Collaboration on Nephrotoxic drugs Bandolier on Nephrotoxic drugs TRIP on Nephrotoxic drugs
Clinical Trials
Ongoing Trials on Nephrotoxic drugs at Clinical Trials.gov Trial results on Nephrotoxic drugs Clinical Trials on Nephrotoxic drugs at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Nephrotoxic drugs NICE Guidance on Nephrotoxic drugs NHS PRODIGY Guidance FDA on Nephrotoxic drugs CDC on Nephrotoxic drugs
Books
Books on Nephrotoxic drugs
News
Nephrotoxic drugs in the news Be alerted to news on Nephrotoxic drugs News trends on Nephrotoxic drugs
Commentary
Blogs on Nephrotoxic drugs
Definitions
Definitions of Nephrotoxic drugs
Patient Resources / Community
Patient resources on Nephrotoxic drugs Discussion groups on Nephrotoxic drugs Patient Handouts on Nephrotoxic drugs Directions to Hospitals Treating Nephrotoxic drugs Risk calculators and risk factors for Nephrotoxic drugs
Healthcare Provider Resources
Symptoms of Nephrotoxic drugs Causes & Risk Factors for Nephrotoxic drugs Diagnostic studies for Nephrotoxic drugs Treatment of Nephrotoxic drugs
Continuing Medical Education (CME)
CME Programs on Nephrotoxic drugs
International
Nephrotoxic drugs en Espanol Nephrotoxic drugs en Francais
Business
Nephrotoxic drugs in the Marketplace Patents on Nephrotoxic drugs
Experimental / Informatics
List of terms related to Nephrotoxic drugs

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

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.

Antibiotics

• 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

• Sulfonamides
• Amphotericin B (Incidence 80-90%)
• Levofloxacin
• Ciprofloxacin
• Rifampin
• Tetracycline
• Acyclovir (only nephrotoxic in intravenous form)
• Pentamidine

Chemotherapy and Immunosuppressants

• Cisplatin
• Methotrexate
• Mitomycin
• Cyclosporine

Heavy Metals

• Mercury Poisoning
• Lead Poisoning
• Arsenic Poisoning
• Bismuth
• Lithium related kidney disorders

• Polydipsia and Nephrogenic Diabetes Insipidus
• Acute Renal Failure

  • Dialysis indications: Creatinine >2.5 or Seizures, ALOC, Rhabdomyolysis

• Chronic kidney disease with fibrosis

AntiHyperlipidemics

• Statins
• Gemfibrozil

• Associated with Acute Renal Failure due to Rhabdomyolysis

• Fenofibrate (Tricor)

• Increases Serum Creatinine without significant decrease in GFR
• Serum Creatinine rise is reversible on stopping Fenofibrate

Chemotherapy

• Cisplatin
• Ifosphamide

• Causes Fanconi's Syndrome

Miscellaneous Drugs

• Chronic Stimulant Laxative use

• Resulting chronic volume depletion and Hypokalemia causes nephropathy

• Radiographic contrast
• ACE Inhibitors

• Expect an increase of Serum Creatinine in Chronic kidney disease

• NSAIDs
• 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

• Mesalamine (Asacol, Pentasa)

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

• Penicillins and Cephalosporins

• Hypersensitivity (fever, rash, arthralgia)

• Sulfonamides

• Vasculitis reaction

• NSAIDs

• Nephrotic Syndrome type reaction

• Rifampin
• Diuretics (Thiazides and furosemide)
• Allopurinol
• Cimetidine
• Ciprofloxacin
• Dilantin

Drugs of abuse

• Cocaine