Cisplatin Amphotericin

Acute tubular necrosis (exogenous toxins) Aminoglycosides, amphotericin, cisplatin, radiocontrast agents, methoxyflurane, outdated tetracyclines, cephalosporins, mithramycin, calcineurin inhibitors, pentamidine, IVIG, ifosfamide, zoledronate, cidofovir, adefovir, tenofovir FENa>2%, UOsm <350, urinary sediment contains granular casts, renal epithelial cells... 

Aminoglycosides, amphotericin B, carboplatin, cisplatin, foscamet, and intravenous contrast dyes... 

Nephrotoxins (N) orototoxins (0) (eg., amphotericin B (N), cisplatin (N/0), cyclosporine (N), furosemide (0), NSAIDs (N), radio contrast (N), vancomycin (N) Additive adverse effects Monitor aminoglycoside SDC and renal function... 

Insulin overdose Miscellaneous Aminoglycosides Amphotericin B Cisplatin ... 

Hypomagnesemia is usually associated with disorders of the intestinal tract or kidneys. Drugs (e.g., aminoglycosides, amphotericin B, cyclosporine, diuretics, digitalis, cisplatin) or conditions that interfere with intestinal absorption or increase renal excretion of magnesium can cause hypomagnesemia. 

Drugs that may interact with zalcitabine include antacids, chloramphenicol, cisplatin, dapsone, didanosine, disulfiram, ethionamide, glutethimide, gold, hydralazine, iodoquinol, isoniazid, metronidazole, nitrofurantoin, phenytoin, ribavirin, vincristine, cimetidine, metoclopramide, amphotericin, aminoglycosides, foscarnet, antiretroviral nucleoside analogs, pentamidine, and probenecid. 

Drugs that may affect tacrolimus include nephrotoxic agents (aminoglycosides, amphotericin B, cisplatin, cyclosporine), antifungals, bromocriptine, calcium channel blockers, cimetidine, clarithromycin, danazol, diltiazem, erythromycin, methylprednisolone, metoclopramide, carbamazepine, phenobarbital, phenytoin, rifamycins, cisapride, chloramphenicol, metronidazole, nefazodone, omeprazole, protease inhibitors, macrolide antibiotics, fosphenytoin, and St. John s wort. 

The severity of aminoglycoside nephrotoxicity is additive with that of vancomycin, polymixin, gallium, furosemide, enflurane, cisplatin, and cephalosporins. Aminoglycoside nephrotoxicity is synergistic with that of amphotericin B and cyclosporine. 

Amphotericin-induced hypomagnesemia may be more profound in patients who develop a divalent cation-losing nephropathy associated with cisplatin (12). 

Based on its considerable nephrotoxic potential, cisplatin should be given after, rather than before, other anticancer drugs and other drugs with a low therapeutic index (for example aminoglycoside antibiotics or bleomycin) that are primarily excreted in the urine in unchanged form. Concomitant use of potentially nephrotoxic agents (for example conventional amphotericin, tacrohmus) with cis-platin should be avoided (279,280). 

Tubular cell toxicity This involves the cellular transport systems mentioned previously and is thus dose dependent to a degree. Examples of tubular cell toxins include aminoglycosides, calcineurin inhibitors, amphotericin, antiviral agents, cisplatin, methotrexate, contrast agents and cocaine. 

Beta-lactam induced renal toxicity can results from their use in monotherapy or when used in combination with other nephrotoxic drugs such as aminoglycosides, amphotericin B, cisplatin, cyclosporine, furosemide, ifosfamide, vancomycin and nephrotoxic p-lactams. While the risk of nephrotoxic injury from monotherapy with p-lactams is relatively low, this risk is substantially increased when multiple drug combinations are required. 

Examples amphotericin B, aminoglycosides, cephaloridine, cisplatin, heavy metals, cysteine conjugates, 4-aminophenol, many others... 

Acute tubular necrosis is the most common presentation of drug-induced kidney disease in hospitalized patients. The primary agents implicated are aminoglycosides, radiocontrast media, cisplatin, amphotericin B, foscarnet, and os-motically active agents. 

Glomerulonephritis Pyelonephritis Nephrotic syndrome Drug-induced renal losses Aminoglycosides Amphotericin B Cyclosporine Diuretics Digitalis Cisplatin... 

Nephrotoxicity (6% to 7% incidence) includes proteinuria, hypokalemia, acidosis, and acute tubular necrosis—usually reversible, but enhanced by vancomycin, amphotericin B, cisplatin, and cyclosporine. 

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