Drugs removed by the kidneys Flashcards
Penicilin
Cancause intersitial nephritis
Accumulation causes CNS side effects e.g. seizures
Opiod analgesiscs
Accumulation causes CNS side effects and respiratory depression
Avoid slow release, use short acting and reduce dose
Or use opioids with minimal renal excretion e.g. fentanyl, oxycodeine and hydromorpheine)
Digoxin
Accumulation causes bradychardia, visual disturbances and mental confusion and aggravates hyperkalaemia
Reduce dose and monitor levels
Hypoglycaemic agents
Can accumulate to cause hypoglycaemia, Avoid long lasting, reduce dose and monitor BGL
Metformin
Often used to treat diabetes as helps weight loss. But avoid as can cause lactic acidosis and accumulation leave to hypoglycaemia.
Avoid if eGFR less than 30, hypovolaemia or sepsis and seek advice if at risk of AKI or undergoing contrast procedure
Herbal preparations
Aristicholic acid in chinese medications can cause interstitial nephritis
Cats claw has inflammatory properties - implicated in causing AKI and hypotension with antihypertensives!
Daily Sodium Intake
Should be 1mmol per kg
first line method for detecting urinary tract obstruction
Ultrasound
What does diabetes cause
Resistance to ADH in the collecting duct
What causes grossly elevated creatinine in AKi
Rhabdomyolysis
Symptoms of Upper airway obstruction
Stridor, choking, snoring
Common feature of septic shock
High lactic acid
Hyperkalaemia management
IV Calcium chloride
Nebulised salbutamol
IV insulin with dextrose
The treatment of a AKI and a pyelonephrosis secondary to renal tract obstruction includes:
Percutaneous nephrostomy
What is the most common cause of AKI
Sepsis
