Toxicity nephrotoxicity

Streptomycin Prevents bacterial protein synthesis by binding to the S12 ribosomal subunit (see also Chapter 45) Bactericidal activity against susceptible mycobacteria Used in tuberculosis when an injectable drug is needed or desirable and in treatment of drug-resistant strains IM, IV renal clearance (half-life 2.5 h) administered daily initially, then 2 x week Toxicity Nephrotoxicity, ototoxicity... 

Flucytosin i.v., 0. ind. systemic mycoses, given in combination with amphotericin B resistance when used as monotherapy bone marrow toxicity, nephrotoxicity, hepatotoxicity avoid other nephrotoxic drugs cytarabin as antagonist... 

Foscarnet Intravenous administration Intravitreal injection Primary toxicity = nephrotoxicity... 

The adverse effects associated with TAC include neurologic toxicity, nephrotoxicity, and electrolyte disturbances such as hyperkalemia and hypomagnesemia (see Table 87-4). The incidence of post-transplant diabetes is approximately 8% to 10% but is often reversible when doses of TAC and/or steroids are reduced. As observed with CSA, most adverse effects related to TAC improve with dosage reduction or discontinuation. 

Major toxicities Nephrotoxicity Severe nausea and vomiting Neurotoxicity (peripheral neuropathy) Ototoxicity (tinnitus/hearing loss) M yelosuppression (mainly thrombocytopaenia)... 

Complex Max. Dose Range (mg/m ) Dose-Limiting Toxicity Nephrotoxicity... 

Safety/Toxicity Aquatic toxicity bacterial toxicity carcinogenicity cytotoxicity dental toxicity DNA damage embryotoxicity genotoxicity im-munotoxicity mitochondrial toxicity nephrotoxicity neurotoxicity phototoxicity skin toxicity ... 

Safety/Toxicity Cytotoxicity deformation of lyid droplets cardiovascular toxicity nephrotoxicity ... 

Safety/Toxicity Acute toxicity algal toxicity aluminum toxicity arsenic toxicity cytotoxicity - - - ecotoxicity - embryotoxicity marine toxicity nephrotoxicity ... 

Effects of repeated ethylene glycol peroral overexposure in treated rats and mice can result in kidney, Hver, and nervous system damage. The most sensitive indicators of ethylene glycol toxicity are disturbances in acid—base balance and nephrotoxic (kidney) effects. Effects of repeated chronic peroral overexposure of diethylene glycol in treated rats result in kidney and Hver damage (48). 

The nephrotoxic amino acid, lyskioalanine [18810-04-3] formed upon alkaline treatment of proteki, was reported ki 1964 (108). Its toxicity seems to be mitigated ki proteki ki that it is not released by normal digestion (109). Naturally occurring new amino acids, which can be classified as protekiaceous or non-protekiaceous, can, as ki the case of those from some legumes, show a remarkable toxicity (110). Eor the details of amino acid toxicity, see reference 6. Enzyme inhibition by amino acids and thek derivatives have been reviewed (111). 

A novel approach to the problem of amiaoglycoside nephrotoxicity has been to search for compounds that can inhibit toxicity without compromising efficacy. A number of agents have been reported to reduce amiaoglycoside toxicity ia animal models the most extensively studied of these is sodium polyaspartate (103—107). 

Gapreomycin, Viomycin, and Enviomycin. Capreomycin (Capastat, Lilly), a bacteriostatic, antimycobacterial peptide mixture isolated from Streptomjces capreolus was first reported in 1961 (106—108). This tuberactinomycin family member, shown in Table 4, was introduced into the U.S. market in 1971 where it has remained a usehil but nephrotoxic and ototoxic second-line alternative to first-line tuberculosis therapies. Because capreomycin is somewhat less toxic than viomycin (tuberoactinomycin B [32988-50-4]) C25H42N23O2Q (109,110), capreomycin has now displaced viomycin in the United States and most other markets. The stmcture of viomycin is shown in Figure 2. The related enviomycin (tuberactinomycin N [33103-22-9]), C23H43N23O2Q,... 

Amphotericin B (15) is an antifimgal macioHde antibiotic produced by Streptomjces nodosus that has been used as an alternative, albeit more toxic, dmg to the antimonials. It acts as a leishmanicide against the visceral and mucocutaneous forms of the disease. To overcome its potentially severe nephrotoxicity, the dmg must be adrninistered over an extended period of time. 

Carboplatin (96) is significantly less toxic in the clinic than cisplatin. Most particularly, it is much less nephrotoxic. Use of a bidentate ligand also ensures formation of a ds complex. Its synthesis begins with cis-diammine platinum diiodide (94) which is reacted with silver sulfate to give cis-diaquodiam mine platinum sulfate (95). This is reacted with the barium salt of 1,1-cyclo-butanedicarboxylic acid to yield carboplatin [23],... 

Other adverse reactions that may be seen with administration of the cephalosporins are headache, dizziness, nephrotoxicity (damage to the kidneys by a toxic substance), malaise, heartburn, and fever. Intramuscular (IM) administration often results in pain, tenderness, and inflammation at the injection site Intravenous (IV) administration has resulted in thrombophlebitis and phlebitis. 

The nurse must carefully monitor fluid intake and output because this drug may be nephrotoxic (harmful to the kidneys). In some instances, the nurse may need to perform hourly measurements of the urinary output. Periodic laboratory tests are usually ordered to monitor the patient s response to therapy and detect toxic drug reactions. 

There is an increased risk of toxicity of MTX when administered with the NSAIDs, salicylates, oral antidiabetic drugs, phenytoin, tetracycline, and probenecid. There is an additive bone marrow depressant effect when administered with other drug known to depress the bone marrow or with radiation therapy. There is an increased risk for nephrotoxicity when MTX is administered with other drug that cause nephrotoxicity. When penicillamine is administered with digoxin, decreased blood levels of digoxin may occur. There is a decreased absorption of penicillamine when the dmg is administered with food, iron preparations, and antacids. 

These dm are contraindicated in patients with known hypersensitivity to the drug or any components of the drug. Because neomycin toxicity can cause nephrotoxicity and ototoxicity, neomycin is used cautiously in patients with extensive bums or trophic ulceration when extensive absorption can occur. 

Xylan-based microparticles were also evaluated regarding their in vitro toxicity. In fact, cross-liked (CLM) and spray-dried microparticles (SDM) based on xylan and ESIOO were produced in order to carry UA and avoid its side effects, namely hepatotoxicity and nephrotoxicity. Additionally, CLM and SDM dispersions at concentrations of 50, 125, 250, and 500 pg/ml were placed in contact with human embiyonic Ixmg fibroblasts (MRC-5 cells)... 

The antibacterial activity of five members (A to E) of the polymyxin group is of a similar nature. However, they are all nephrotoxic although this effect is much reduced with polymyxins B and E (colistin). Colistin sulphomethate sodium is the form of colistin used for parenteral administration. Sulphomyxin sodium, a mixture of sulphomethylated polymyxin B and sodium bisulphite, has the action and uses of polymyxin B sulphate, but is less toxic. 

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