Colic, renal

Severe pain in the loin lasting several hours and which is recurring requires referral to investigate underlying cause. One of the systems that need to be investigated is the renal system. Pain originating from kidney disorders and renal colic (renal calculi) initially presents with loin pain and may radiate to the back or spread downwards to the iliac fossa, suprapubic area and in males into the scrotum. 

Spasmolysis by N-butylscopolamine in biUary or renal colic (p. 126). Because of its quaternary nitrogen, this drug does not enter the brain and requires parenteral administratioa Its spasmolytic action is especially marked because of additional ganglionic blocking and direct muscle-relaxant actions. 

Alkalinization of urine Hematuria, renal colic, costovertebral pain, and formation of urate stones associated with use in gouty patients may be prevented by alkalization of urine and liberal fluid intake monitor acid-base balance. 

Adverse reactions may include headache anorexia nausea vomiting urinary frequency hypersensitivity reactions sore gums flushing dizziness anemia hemolytic anemia (possibly related to G-6-PD deficiency) nephrotic syndrome hepatic necrosis aplastic anemia exacerbation of gout uric acid stones with or without hematuria renal colic or costovertebral pain. 

Renal colic Pilocarpine may increase ureteral smooth muscle tone and could theoretically precipitate renal colic (or ureteral reflux ), particularly in patients with... 

Holdgate A, Pollock T. Systematic review of the relative efficacy of non-steroidal anti-inflammatory drugs and opioids in the treatment of acute renal colic. BMJ 2004 328 1401-4. 

Nephrotoxicity/hepatotoxicity occurs occasionally, manifested as dark urine/ stools, pain in lower back, jaundice, dysuria, crystalluria, renal colic/calculi. 

It is used in postoperative pain and renal colic pain. 

Sulfonamides also cause renal irritation and may precipitate renal colic. Crystalluria, haematuria and albuminuria can also occur which may lead to the development of oliguria and anuria. 

N.A. Parietaria judaica L. Flavonoids, tannins.99 A diuretic, demulcent, laxative. Restorative action on the kidneys, for nephritis, pyelitis, kidney stones, renal colic, cystitis, and edema. 

The furanochromone khellin (43) from the seeds of Ammi visnaga is a coronary vasodilator, and it has long been used in Egypt as a spasmolytic to relieve renal colic and ureteral spasms due to schistosomiasis. The corresponding dihydroxy compound is also a vasodilator, but other related compounds are inactive (5lCRV(48)543). 

The plant Achillea clusiana from the mountains of Bulgaria contains the new 2-epi-chIoroklotzchin (256), which is the first report of a halogenated sesquiterpene lactone from Achillea genus (512). Chloroform was used to process the plant. The Egyptian medicinal plant Ambrosia maritima, which is still used to treat renal colic and other aliments, has afforded 1 lp-hydroxy-13-chloro-l 1,13-dihydrohymenin (257) (513). Eupaglehnins E (258) and F (259) are novel germacranolides isolated... 

Hydromorphone is also indicated for use during surgical procedures, and pain associated with trauma to bone and tissue, biliary colic, myocardial infarction, severe burns, and renal colic. 

Drug-specific toxicities ritonavir, gastrointestinal distress saquinavir, hard gel capsules indinavir, renal colic nelfinavir, diarrhea amprenavir, nausea and vomiting. Increased risk of poor adherence with long-term treatment, leading to resistance... 

Pain due to spasm of visceral smooth muscle, e.g. biliary, renal colic, when severe, requires a substantial dose of morphine, pethidine or buprenorphine. These drugs themselves cause spasm of visceral smooth muscle and so have a simultaneous action tending to increase the pain. Phenazocine and buprenorphine are less liable to cause spasm. An antimuscarinic drug such as atropine or hyoscine may be given simultaneously to antagonise this effect. 

Chang CH, Wang CJ, Yen YC, Hsu SJ. Effectiveness of sublingual buprenorphine and intramuscular pethidine in acute renal colic. Formosan J Surg 2002 35 9-13. 

Kohan AD, Armenakas NA, Fracchia JA. Indinavir urohthiasis an emerging cause of renal colic in patients with human immunodeficiency virus. J Urol 1999 161(6) 1765-8. 

Galassi P, Vicentini C, Scapellato F, Laurenti C. L impiego dell indometacina e del metamizolo per via endovenosa nella colica renale. [Use of indomethacin and metamizole administered intravenously in renal colic. Comparative study.] Minerva Urol 1983 35(4) 295-300. 

In a randomized, double-blind study in 94 patients with acute renal colic, morphine had equal analgesic efficacy to pethidine and a similar adverse effects profile (4). 

O Connor A, Schug SA, Cardwell H. A comparison of the efficacy and safety of morphine and pethidine as analgesia for suspected renal colic in the emergency setting. J Accid Emerg Med 2000 17(4) 261. ... 

A 42-year-old patient presented with generalized pruritus, erythema, urticaria, facial angioedema, dysphagia, dysphonia, and dizziness 15 minutes after a single intramuscular dose of pethidine 100 mg for severe renal colic (15). Prick tests and intradermal tests with pethidine and other compounds confirmed an allergic reaction to pethidine. 

Example A study in 1,219 patients of the ATHENA (AIDS Therapy Evaluation National Centre) cohort of patients infected with HIV receiving antiretroviral therapy in the Netherlands showed a frequency of urological symptoms (including nephrolithiasis, renal colic, flank pain, hematuria, renal insufficiency, or nephropathy) of 8.3 per 100 treatment-years for indinavir compared to 0.8 per 100 treatment-years for other HIV protease inhibi-... 

Padberg J, Eritsche L, Bergmann E, Schurmann D, Suttorp N. Nephropathy and renal colic in patients treated with indinavir, ritonavir plus indinavir or ritonavir plus saquinavir. AIDS 1999 13 2173-2174. 

Balkan nephropathy is a chronic tuhulointerstitial disease with occult, insidious onset, usually progressing slowly with no apparent signs of symptoms. After a long asymptomatic period, the disease is manifested as chronic renal failure. Less commonly hlunt lumbar pain or renal colic may develop or, occasionally, dysuric symptoms induced by urinary tract infechon. If hematuria exists, urothelial tumor should be suspected. In an advanced case polyuria and nocturia are present due to impaired concentrating ability of the kidneys. The disease is tolerated well and the patients preserve their working ability until advanced stages of renal failure [18, 76, 88, 89]. 

Adverse/Toxic Long-term therapy may result in acidotic state. Nephrotoxicity/hepatotoxicity occurs occasionally, manifested as dark urine/stools, pain in lower back, jaundice, dysuria, crystalluria, renal colic/calculi. Bone marrow depression may be manifested as aplastic anemia, thrombocytopenia, thrombocytopenic purpura, leucopenia, agranulocytosis, hemolytic anemia. 

Atropine sulfate USP Atropine tannate Atratran 0.5 mg (oral i.v or s.c.) 0.5-1.0% ophthalmic solution 1-2 mg (tablet) Slow absorption with sustained Mydriatic with long recovery period preanesthetic medication to decrease secretions, treatment of Parkinsonism, and anti-ChE poisoning Antispasmodic in ureteral and renal colic... 

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