Renal adverse drug reactions

Continual cardiac monitoring assists the nurse in assessing the patient for adverse drug reactions. If the patient is acutely ill or is receiving one of these drugs par-enterally, the nurse measures and records the fluid intake and output. The primary health care provider may order subsequent laboratory tests to monitor the patient s progress for comparison with tests performed in the preadministration assessment, such as an ECG, renal and hepatic function tests, complete blood count, serum enzymes, and serum electrolytes. The nurse reports to the primary care provider any abnormalities or significant... 

Every patient receiving antimicrobial therapy for skin and soft tissue infections must be monitored for efficacy and safety. Efficacy typically is manifested by reductions in temperature, white blood cell count, erythema, edema, and pain that begin within 48 to 72 hours. To ensure safety, dose antibiotics according to renal and hepatic function as appropriate, and monitor for and minimize adverse drug reactions, allergic reactions, and drug interactions. 

Assess the patient daily for any new signs or symptoms of infection. Evaluate the patient for adverse drug reactions, drug allergies, and drug interactions. Have all antibiotics been dose adjusted for renal or hepatic dysfunction ... 

Corsonello A, Redone C, Corica F, Mussi C, Carbonin P, Antonelli Inc. Concealed renal insufficiency and adverse drug reactions in elderly hospitalized patients. Arch Intern Med 2005 165(7) 790-5. 

Penicillins are rapidly eliminated, particularly by glomerular filtration and renal tubular secretion, With some (e.g, cloxacillin), metabolic transformation occurs, especially in anuric patients, When renal function is impaired, 7-10% of the antibiotic will be inactivated by the liver per hour. Adverse drug reactions are ... 

Zhao SZ, Reynolds MW, Lejkowith J, Whelton A, Arellano FM. A comparison of renal-related adverse drug reactions between rofecoxib and celecoxib, based on the World Health Organization/Uppsala Monitoring Centre safety database. Chn Ther 2001 23(9) 1478-91. 

The Australian Adverse Drug Reactions Advisory Committee has also received 12 reports of pure red cell aplasia associated with the use of epoetin alfa (Eprex) in patients with renal insufficiency (86). The patients were aged 28-76 years and the duration of epoetin alfa use, when known, was 4—13 months. 

In a comparison of high doses (750-1000 mg/day) and low doses (125 mg every other day) of penicillamine in the treatment of early diffuse systemic sclerosis, seven of the 34 patients in the high-dose group had proteinuria (over 1 g/day) compared with only one of the 32 in the low-dose group (45). Rheumatoid arthritis is a risk factor for renal disease, and the distinction from adverse drug reactions can be difficult in these patients (SED-14, 729). 

The Austrian Adverse Drug Reactions Advisory Committee received three reports of severe electroljde disturbances associated with an oral bowel-cleansing solution containing sodium phosphate solution (Fleet Phospho-Soda Buffered Saline Laxative Mixture), used as a bowel preparation for colonoscopy (5). Prescribers are advised to be aware of complications of the use of phosphate enemas, particularly in infants, elderly or debilitated patients, patients with congestive heart failure, and patients with impaired renal function. 

Alendronate therapy of a patient with chronic lymphocytic leukaemia has been associated with the onset of acufe granulomatous interstitial nephritis, a relatively rare renal pathology primarily caused by adverse drug reactions [27]. In this case, treatment with oral alendronate was initiated 2 weeks before... 

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