Renal disease, drug contraindications

Thiabendazole is contraindicated in patients with known hypersensitivity. Thiabendazole is used with caution in patients with hepatic or renal disease. Thiabendazole is a Pregnancy Category C drug and is used during pregnancy only if the potential benefit outweighs the risk to the fetus. When thiabendazole is administered with the xanthine derivatives, the plasma level of the xanthine may increase to toxic levels. It is important to monitor xanthine plasma levels closely in case a dosage reduction is necessary. 

Metformin is contraindicated in patients with heart failure, renal disease, hypersensitivity to metformin, and acute or chronic metabolic acidosis, including ketoacidosis. The drug is also contraindicated in patients older than 80 years and during pregnancy (Pregnancy Category B) and lactation. 

The antineoplastic dm are contraindicated in patients with leukopenia, thrombocytopenia, anemia, serious infections, serious renal disease, or known hypersensitivity to the drug and during pregnancy (see Display 55-1 for pregnancy classifications of selected antineoplastic drag s). 

Lower goals for patients with diabetes or renal disease Initial drug choices (unless contraindicated)... 

Contraindications Anuria, drug-induced or preexisting hyperkalemia, progressive or severe renal disease, severe hepatic disease... 

Biguanide drugs are contraindicated in patients with renal disease, alcoholism, hepatic disease, or conditions predisposing to tissue anoxia (eg, chronic cardiopulmonary dysfunction) because of an increased risk of lactic acidosis induced by biguanide drugs. 

Drug of choice among intravascular agents more effective for glaucoma with inflammation than urea or glycerol Contraindicated in patients with renal disease caution in hepatic impairment Safe to use in diabetic patients (not metabolized to provide calories),... 

Celecoxib (Celebrex), a COX-2 inhibitor, is used to treat osteoarthritis, but more data is needed to determine how safe the medieation is for eertain clients. Research shows an increase in heart attacks and strokes, and the drug is contraindicated in clients with liver and renal disease. The nurse should refer the client to the HCR... 

There are numerous relative contraindications to combination opioids and NSAIDs. They include but are not limited to a past medical history of GI bleeding, history of chronic renal disease, a history of abuse of drugs or other substances, a history of seiziu es related to head trauma, brain tumor, or increased intracranial pressure, or documented urinary retention with use of narcotics. 

Relative contraindications the drug is listed as a Pregnancy Category B drug. It is unknown whether the drug is secreted via lactation. The drug has not been studied in patients with end-stage renal disease or severe hepatic dysfunction. 

The oral antidiabetic drugs are contraindicated in patients with known hypersensitivity to tiie drugs, DKA, severe infection, or severe endocrine disease. The first generation sulfonylureas (chlorpropamide, tolazamide, and tolbutamide) are contraindicated in patients with coronary artery disease or liver or renal dysfunction. Other sulfonylureas are used cautiously in patients with impaired liver function because liver dysfunction can prolong the drug s effect. In addition, the sulfonylureas are used cautiously in patients with renal... 

The a-glucosidase inhibitors are contraindicated in patients with a hypersensitivity to the drug, diabetic ketoacidosis, cirrhosis, inflammatory bowel disease, colonic ulceration, partial intestinal obstruction or predisposition to intestinal obstruction, or chronic intestinal diseases. Acarbose and miglitol are used cautiously in patients with renal impairment or pre-existing gastrointestinal (GI) problems such as irritable... 

Ergonovine is contraindicated in those with known hypersensitivity to the drug, hypertension, and before the delivery of the placenta Ergonovine is used cautiously in patients with heart disease obliterative vascular disease, renal or hepatic disease and during lactation. 

If drug therapy is indicated, assess the patient for contraindications (e.g., esophageal disease or severe renal impairment for bisphosphonate therapy). 

In general, consider the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy when prescribing nitrofurantoin. Anuria, oliguria, or significant impairment of renal function (Ccr less than 60 mL/min or clinically significant elevated serum creatinine) are contraindications. 

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