Nephrotoxic drugs: Difference between revisions
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==Overview== | ==Overview== | ||
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:*:* Decreased [[Creatinine Clearance]] after 2 weeks of use | :*:* Decreased [[Creatinine Clearance]] after 2 weeks of use | ||
:*:* Changes persisted for at least 3 weeks off [[Aspirin]] | :*:* Changes persisted for at least 3 weeks off [[Aspirin]] | ||
*[[ | *[[Bevacizumab]] | ||
*[[Carbon tetrachloride]] | *[[Carbon tetrachloride]] | ||
*[[Cimetidine]] | *[[Cimetidine]] | ||
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==Drugs of abuse== | ==Drugs of abuse== | ||
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Revision as of 22:13, 9 August 2012
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WikiDoc Resources for Nephrotoxic drugs |
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Evidence Based Medicine |
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Cochrane Collaboration on Nephrotoxic drugs |
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US National Guidelines Clearinghouse on Nephrotoxic drugs NICE Guidance on Nephrotoxic drugs
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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.
Antibiotics
- Acyclovir (only nephrotoxic in intravenous form)
- 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
- Amphotericin B (Incidence 80-90%)
- Ciprofloxacin
- Chloroquine
- Erythromycin
- Foscarnet
- Gentamycin
- Hydroxychloroquine
- Indinavir
- Isoniazide
- Levofloxacin
- Methicillin
- Pentamidine
- Quinine
- Rifampin
- Sulfonamides
- Tetracycline
- Tenofovir
- Trimethadione
- Vancomycin
Chemotherapy and Immunosuppressants
Heavy Metals and Poisons
- Polydipsia and Nephrogenic Diabetes Insipidus
- Acute Renal Failure
- Dialysis indications: Creatinine >2.5 or Seizures, ALOC, 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
- Associated with Acute Renal Failure due to Rhabdomyolysis
Chemotherapy
- Causes Fanconi's Syndrome
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
- Low dose Aspirin reduces Renal function in elderly
- Infliximab
- Interferons
- Mesalamine (Asacol, Pentasa)
- Mesalamine is an NSAID analog and has systemic absorption from the bowel
- Nephrotic Syndrome type reaction
- Vasculitis reaction