Drug Induced Kidney Injury - Lecture Gurusamy Fall 2024-1 PDF

TREATMENT OF RENAL DISEASES Dr. Narasimman Gurusamy Assistant Professor College of Pharmacy 954-262-1322 [email protected] LEARNING OBJECTIVES Drugs to stop or reverse CKD progression, targeting its cause. Drugs or procedures to m...

TREATMENT OF RENAL DISEASES Dr. Narasimman Gurusamy Assistant Professor College of Pharmacy 954-262-1322 [email protected] LEARNING OBJECTIVES Drugs to stop or reverse CKD progression, targeting its cause. Drugs or procedures to manage and prevent CKD complications  CHRONIC KIDNEY DISEASES DEFINITION AND ORIGIN CKD is defined by the presence of kidney damage or decreased kidney function for 3 or more months, irrespective of the cause. eGFR 3.5 g/24h), resembling a nephrotic syndrome. Lithium, and Can also contribute to pre-renal injury. chronic Heroin.  CHRONIC INTERSTITIAL NEPHRITIS Cyclosporine: Lithium: Inability to concentrate the urine May cause pre-renal and chronic (polyuria/polydipsia) due to reduced effect of interstitial nephritis after 6-12 months of ADH. therapy. Long-term effects: Interstitial fibrosis, Induces sustained renal endothelial tubular atrophy, cell injury causing chronic renal glomerular sclerosis. ischemia. Increased risk with: Risk factors: High lithium levels, Dehydration, Chronic treatment and ACEI-ARB use, and high dose. Poor monitoring of lithium levels.  DRUG-INDUCED RHABDOMYOLYSIS Rhabdomyolysis: Breakdown of skeletal Factors Influencing Rhabdomyolysis: muscle tissue leads to the release of Dose, duration, and co-administration with other myoglobin into the bloodstream. drugs. Myoglobin can precipitate within renal Individual patient factors (e.g., pre-existing tubules, causing cellular damage conditions). (Nephrotoxic). Several drugs can cause rhabdomyolysis Patient Presentation: (mechanism unclear). Unexplained muscle pain, weakness, or dark urine (indicative of myoglobinuria). Triad: Myalgia, weakness, and myoglobinuria (tea- colored urine). Patients experiencing these symptoms should contact a healthcare professional immediately.  Common Drugs That Induce Rhabdomyolysis: Statins Psychiatric Agents Abused Substances Other Agents Lovastatin Amitriptyline Alcohol Amphotericin B Pravastatin Haloperidol Cocaine Arsenic Atorvastatin Fluoxetine Heroin/Opiates Azathioprine Rosuvastatin Lithium Amphetamines Carbon Monoxide Simvastatin Doxepin Methamphetamines Penicillamine Gemfibrozil Venlafaxine Lysergic Acid Succinylcholine