Class Talk Fall 2016

Vancomycin is an anti-infective that is used to treat serious and potentially life-threatening infections. It should be used cautiously in patients with renal impairment (dosage reduction required if Cc <80 mL/min) because the risk of toxicity increases with high, prolonged blood concentration. Nephrotoxicity can occur when taken with other nephrotoxic drugs such as aspirin, cyclosporine and cisplatin. Patients should be monitored for albumin, casts, or cells in the urine or decreased specific gravity, CBC, and renal function periodically during therapy. It may also increase BUN levels. IV vancomycin is almost entirely eliminated through the kidneys.

Skyscape. (2015). Skyscape Medical Resources (Version 2.4.5)[Mobile application software]. Retrieved from http://itunes.apple.com

Vancomycin is an anti-infective that is used to treat serious and potentially life-threatening infections. It should be used cautiously in patients with renal impairment (dosage reduction required if Cc <80 mL/min) because the risk of toxicity increases with high, prolonged blood concentration. Nephrotoxicity can occur when taken with other nephrotoxic drugs such as aspirin, cyclosporine and cisplatin. Patients should be monitored for albumin, casts, or cells in the urine or decreased specific gravity, CBC, and renal function periodically during therapy. It may also increase BUN levels. IV vancomycin is almost entirely eliminated through the kidneys.

Skyscape. (2015). Skyscape Medical Resources (Version 2.4.5)[Mobile application software]. Retrieved from http://itunes.apple.com

Vancomycin is an anti-infective that is used to treat serious and potentially life-threatening infections. It should be used cautiously in patients with renal impairment (dosage reduction required if Cc <80 mL/min) because the risk of toxicity increases with high, prolonged blood concentration. Nephrotoxicity can occur when taken with other nephrotoxic drugs such as aspirin, cyclosporine and cisplatin. Patients should be monitored for albumin, casts, or cells in the urine or decreased specific gravity, CBC, and renal function periodically during therapy. It may also increase BUN levels. IV vancomycin is almost entirely eliminated through the kidneys.

Skyscape. (2015). Skyscape Medical Resources (Version 2.4.5)[Mobile application software]. Retrieved from http://itunes.apple.com

Vancomycin is an anti-infective that is used to treat serious and potentially life-threatening infections. It should be used cautiously in patients with renal impairment (dosage reduction required if Cc <80 mL/min) because the risk of toxicity increases with high, prolonged blood concentration. Nephrotoxicity can occur when taken with other nephrotoxic drugs such as aspirin, cyclosporine and cisplatin. Patients should be monitored for albumin, casts, or cells in the urine or decreased specific gravity, CBC, and renal function periodically during therapy. It may also increase BUN levels. IV vancomycin is almost entirely eliminated through the kidneys.

Skyscape. (2015). Skyscape Medical Resources (Version 2.4.5)[Mobile application software]. Retrieved from http://itunes.apple.com

Ibuprofen is a very common OTC medication almost everyone carries in their household. It is used for the treatment of mild to moderate pain, inflammation and fever. This medication must be used cautiously with renal disease as it may increase renal toxicity. In geriatrics, there is an increased risk in adverse reactions secondary to age-related decrease in renal function. Lab test considerations for kidney function include BUN, serum creatinine should be evaluated periodically in patients receiving prolonged therapy.

Skyscape. (2015). Skyscape Medical Resources (Version 2.4.5)[Mobile application software]. Retrieved from http://itunes.apple.com

Vancomycin is a nephrotoxic drug that is widely administered in the hospital setting. It is an antibiotic that is eliminated unchanged by the kidneys. In patients with renal impairment, dosage may be reduced. It is poorly absorbed through the GI tract, therefore it is mostly given via IV infusion. It is well distributed to most body fluids and tissues through IV infusion. It is important to check trough levels before administering vancomycin to avoid overdose. Also monitor I&O, cloudy or pink urine may be a sign of nephrotoxicity.

Vancomycin is a nephrotoxic drug that is widely administered in the hospital setting. It is an antibiotic that is eliminated unchanged by the kidneys. In patients with renal impairment, dosage may be reduced. It is poorly absorbed through the GI tract, therefore it is mostly given via IV infusion. It is well distributed to most body fluids and tissues through IV infusion. It is important to check trough levels before administering vancomycin to avoid overdose. Also monitor I&O, cloudy or pink urine may be a sign of nephrotoxicity.

Vancomycin is a nephrotoxic drug that is widely administered in the hospital setting. It is an antibiotic that is eliminated unchanged by the kidneys. In patients with renal impairment, dosage may be reduced. It is poorly absorbed through the GI tract, therefore it is mostly given via IV infusion. It is well distributed to most body fluids and tissues through IV infusion. It is important to check trough levels before administering vancomycin to avoid overdose. Also monitor I&O, cloudy or pink urine may be a sign of nephrotoxicity.

Digoxin

Therapeutic Class: antiarrhythmic, inotropic

Pharmacologic Class: digitalis glycosides

Metabolism/Excretion: Excreted almost entirely unchanged by the kidneys.

Use cautiously in patients with renal impairment (decreased dose required). Geri: very sensitive to toxic effect; dose adjustments required for age related decrease in renal function and body weight.

Check serum digoxin levels. Therapeutic serum digoxin levels 0.5-2 ng/ml.  Elder patients are at an increased risk for toxic effects of digoxin (Appears on Beers list) due to age-related decreased renal clearance, which can exist even when serum creatinine levels are normal. Digoxin requirements may change and a formerly therapeutic dose can become toxic.

S/S of toxicity: abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and other arrhythmias. If these appear, withhold drug.

 

Reference:

Skyscape. (2016). Skyscape Medical Library (Version 2.4.9) [Mobil application software]. Retrieved from http://itunes.apple.com.

Hello everyone, I chose to look into the effects of ACE inhibitors on kidney function. As we all know, ACE inhibitors lower blood pressure. They are most commonly used to treat hypertension. A good example would be Lisinopril. Lisinopril is beneficial for patients with diabetic nephropathy. How does it work? Lisinopril lowers glomerular filtration pressure by decreasing levels of angiotensin II. It also reduces proteinuria, which is a complication of kidney disease that further damages the glomeruli. By this mechanism, Lisinopril slows the progression of renal disease. However, it is contraindicated for patients with bilateral renal artery stenosis. This renal disorder requires that glomerular filtration be maintained, so an ACE inhibitor would be a poor choice of medication.