Pain Management
Consider kidney risks before using an NSAID
As a hospital pharmacist, you will be asked more, which NSAID is preferred in patients with kidney disease?.. There is NOT a “safest” NSAID for the kidneys . You might’ve heard that short-acting NSAIDs (ibuprofen, etc) are least kidney toxic. But this isn’t supported by evidence. The real key is to use the lowest NSAID dose for the s…
قراءة المزيد
Side Effects
Kidney problems when CLARITHROmycin is combined with CCBs
As a clinical pharmacist, you will get alerts about kidney problems when clarithromycin is combined with a calcium channel blocker (amlodipine, etc). Do your part... Clarithromycin is a strong 3A4 inhibitor that can slow the metabolism of calcium channel blockers and increase their levels. This can lead to hypotension , edema, bradycardia an…
قراءة المزيد
Nephrotoxicity
Improve safety with IV contrast agents
As a hospital pharmacist, you will field questions about the safe use of IV contrast. Think of IV contrast as two classes that aren’t interchangeable... Gadolinium-based contrast ( Magnevist, Omniscan, etc) is often used for MRI, and Iodine-based ( Omnipaque, Ultravist, Visipaque, Optiray, etc) for CT. Evaluate allergies. Iodine-base…
قراءة المزيد
Side Effects
Amphotericin B–related nephrotoxicity
Amphotericin B is a polyene antifungal agent that acts by binding directly to ergosterol on the fungal cell membrane, resulting in disruption of membrane integrity and cell death. Amphotericin B has activity against a very wide range of clinically important yeasts and molds. Resistance to amphotericin B is rare. Amphotericin B has been the gold standard for t…
قراءة المزيد
Pain Management
Kidney risks of non-steroidal anti-inflammatory drugs (NSAIDs)
As a pharmacist, you will see more focus on the kidney risks of non-steroidal anti-inflammatory drugs (NSAIDs). Some government and medical groups are now educating providers to avoid giving NSAIDs to patients at risk for kidney problems. Think about a patient's risk before suggesting an NSAID. It's usually okay for patients with …
قراءة المزيد
Nephrotoxicity
Contrast-induced nephropathy prevention strategy
Overview ㅡ Risk factors for contrast-induced nephropathy include creatinine clearance less than 60 mL/min (stages 3–5 chronic kidney disease), diabetes mellitus (with renal insufficiency), hypertension, chronic heart failure, cirrhosis, nephrosis, age over 75 years, cholesterol emboli syndrome, and multiple myeloma. Additional risk factors include hypovolemia, in…
قراءة المزيد
Pain Management
NSAIDs (dose and duration) in high-CV-risk patients
All NSAIDs have a boxed warning about increased risk of CV events. Naproxen ( Naprofen ) , celecoxib ( Celebrex ) and probably ibuprofen ( Brufen ) are associated with less cardiovascular risk than other NSAIDs!.. Results from the first big study that directly compares chronic NSAIDs in high-CV-risk patients. It suggests celecoxib, naproxen, and ibuprofen all h…
قراءة المزيد
Social Plugin