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drug dosing in kidney failure

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https://www.readbyqxmd.com/read/28423123/n-acetylcysteine-versus-dopamine-to-prevent-acute-kidney-injury-after-cardiac-surgery-in-patients-with-preexisting-moderate-renal-insufficiency
#1
Omer Faruk Savluk, Fusun Guzelmeric, Yasemin Yavuz, Deniz Cevirme, Emre Gurcu, Halide Ogus, Tulay Orki, Tuncer Kocak
Objective: Acute kidney injury after cardiac surgery is associated with mortality and morbidity. Therefore, strategies to prevent acute kidney injury are very important. The aim of this placebo-controlled randomized double-blind study was to compare the prophylactic efficacy of N-Acetylcysteine and dopamine administration in patients with pre-existing moderate renal insufficiency who were undergoing cardiopulmonary bypass. Methods: This study included 135 patients with pre-existing moderate renal insufficiency who were scheduled for coronary artery bypass grafting surgery...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28417439/clinical-pharmacokinetics-of-sacubitril-valsartan-lcz696-a-novel-angiotensin-receptor-neprilysin-inhibitor
#2
REVIEW
Surya Ayalasomayajula, Thomas Langenickel, Parasar Pal, Sreedevi Boggarapu, Gangadhar Sunkara
Sacubitril/valsartan (LCZ696) is indicated for the treatment of heart failure with reduced ejection fraction. Absorption of sacubitril/valsartan and conversion of sacubitril (prodrug) to sacubitrilat (neprilysin inhibitor) was rapid with maximum plasma concentrations of sacubitril, sacubitrilat, and valsartan (angiotensin receptor blocker) reaching within 0.5, 1.5-2.0, and 2.0-3.0 h, respectively. With a two-fold increase in dose, an increase in the area under the plasma concentration-time curve was proportional for sacubitril, ~1...
April 17, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28399053/short-course-regimens-of-liposomal-amphotericin-b-for-the-treatment-of-mediterranean-visceral-leishmaniasis-in-children-an-11-year-retrospective-study-at-a-tertiary-care-center
#3
Panagiotis Krepis, Ioanna Argyri, Adamantia Krepi, Areti Syrmou, Nikos Spyridis, Maria Tsolia
BACKGROUND: Visceral leishmaniasis (VL) remains an important public health problem in endemic regions. Current anti-leishmanial agents share several limitations including potentially serious side effects and the risk of clinical failure. OBJECTIVES: Aim of the present study was to examine the effectiveness and safety of short-course liposomal amphotericin B (L-AmB) regimens in the treatment of childhood VL in our area. METHODS: The cases of 43 VL patients (20 males, 23 females, mean age 4...
April 10, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28394553/drug-induced-oral-ulcerations-case-report
#4
Vanja Vučičević Boras, Snježana Židovec-Lepej, Branka Marinović, Sven Seiwerth, Ivana Škrinjar, Dražen Pulanić, Danica Vidović Juras
A 70-year-old patient was admitted to the Department of Oral Medicine for multiple oral ulcerations on the left buccal mucosa, around 0.5 cm in diameter, as well as on the gingiva. Otherwise, the patient suffered from chronic lymphocytic leukemia, hypogammaglobulinemia, chronic renal insufficiency, with complete afunction of the right kidney, asthma, hypertension, gastritis and prostate hyperplasia. Differential diagnosis of oral ulcerations included drug induced oral ulcerations, paraneoplastic pemphigus, viral ulcerations (cytomegalovirus, herpes simplex viruses), fungal ulcerations (candidiasis, aspergillosis, histoplasmosis, cryptococcosis) and bacterial ulcerations, as well as neutropenic ulcers...
June 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/28356904/clinical-utility-of-patiromer-sodium-zirconium-cyclosilicate-and-sodium-polystyrene-sulfonate-for-the-treatment-of-hyperkalemia-an-evidence-based-review
#5
REVIEW
Mario V Beccari, Calvin J Meaney
INTRODUCTION: Hyperkalemia is a serious medical condition that often manifests in patients with chronic kidney disease and heart failure. Renin-angiotensin-aldosterone system inhibitors are known to improve outcomes in these disease states but can also cause drug-induced hyperkalemia. New therapeutic options exist for managing hyperkalemia in these patients which warrant evidence-based evaluation. AIM: The objective of this article was to review the efficacy and safety evidence for patiromer, sodium zirconium cyclosilicate (ZS9), and sodium polystyrene sulfonate (SPS) for the treatment of hyperkalemia...
2017: Core Evidence
https://www.readbyqxmd.com/read/28321326/first-canadian-case-report-of-kidney-transplantation-from-an-hiv-positive-donor-to-an-hiv-positive-recipient
#6
Georges Ambaraghassi, Héloïse Cardinal, Daniel Corsilli, Claude Fortin, Marie-Chantal Fortin, Valérie Martel-Laferrière, Jacques Malaise, Michel R Pâquet, Danielle Rouleau
RATIONALE: Kidney transplantation has become standard of care for carefully selected patients living with human immunodeficiency virus (HIV) and end-stage renal disease (ESRD) in the highly active antiretroviral therapy (HAART) era. American and European prospective cohort studies have reported similar patient and graft survival compared with HIV-negative kidney transplant recipients. Despite an increased rate of acute rejection, partially due to drug interactions, HIV immunovirologic parameter generally remains under control during immunosuppression...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28314825/increased-plasma-exposures-of-conjugated-metabolites-of-morinidazole-in-renal-failure-patients-a-critical-role-of-uremic-toxins
#7
Fandi Kong, Xiaoyan Pang, Kan Zhong, Zitao Guo, Xiuli Li, Dafang Zhong, Xiaoyan Chen
Morinidazole is a 5-nitroimidazole drug. Its sulfate conjugate M7 was a sensitive substrate of organic anion transporter 1 (OAT1) and OAT3, whereas N+-glucuronides M8-1 and M8-2 were only OAT3 substrates. In chronic renal failure (CRF) patients, plasma exposures of the three conjugates increased by 15-fold, which were also found in 5/6 nephrectomized (5/6 Nx) rats in this study. Although the transcriptions of Oat1 and Oat3 in 5/6 Nx rat kidneys decreased by 50%, no difference was observed on the three conjugate uptakes between control and 5/6 Nx rat kidney slices...
March 17, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28242634/ketone-body-infusion-with-3-hydroxybutyrate-reduces-myocardial-glucose-uptake-and-increases-blood-flow-in-humans-a-positron-emission-tomography-study
#8
Lars C Gormsen, Mads Svart, Henrik Holm Thomsen, Esben Søndergaard, Mikkel H Vendelbo, Nana Christensen, Lars Poulsen Tolbod, Hendrik Johannes Harms, Roni Nielsen, Henrik Wiggers, Niels Jessen, Jakob Hansen, Hans Erik Bøtker, Niels Møller
BACKGROUND: High levels of ketone bodies are associated with improved survival as observed with regular exercise, caloric restriction, and-most recently-treatment with sodium-glucose linked transporter 2 inhibitor antidiabetic drugs. In heart failure, indices of ketone body metabolism are upregulated, which may improve energy efficiency and increase blood flow in skeletal muscle and the kidneys. Nevertheless, it is uncertain how ketone bodies affect myocardial glucose uptake and blood flow in humans...
February 27, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28236794/pharmaceutical-care-practice-in-patients-with-chronic-kidney-disease
#9
Dadier Antonio Arroyo Monterroza, José Francisco Castro Bolivar
INTRODUCTION: The impact of chronic kidney disease in health is no longer just a patient-physician issue, not only in terms of the increase in the number of patients diagnosed, but also regarding the human and economic cost for health systems. That is why Pharmaceutical Care should include SOPs structured by criteria reached by consensus to conduct Pharmaceutical Care Practice, which will enable to prevent, identify and solve any negative outcomes in patients that are associated with medication...
March 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28230617/acute-kidney-injury-after-efavirenz-tenofovir-disoproxil-fumarate-emtricitabine-atripla-overdose
#10
Thomas Havenith, David Burger, Maarten J Visschers, Jolanda Schippers, Astrid O Lashof
We describe a patient with acute renal failure and irreversible kidney damage after an overdose with the fixed dose combination of efavirenz/tenofovir disoproxil fumarate/emtricitabine (Atripla). The acute kidney injury was most probably caused by tenofovir. Efavirenz and emtricitabine seemed relatively safe in overdose. The pharmacokinetics in overdose of all 3 drugs and the effect of hemodialysis on the tenofovir clearance were studied by measuring the plasma concentrations and by the use of clinical pharmacokinetic software...
April 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28129817/-dalbavancin-pharmacokinetic-and-pharmacodynamic-parameters
#11
José Ramón Azanza, Belén Sádaba, Joana Reis
Dalbavancin is a new lipoglycopeptide antibiotic whose structure influences its pharmacokinetic profile. It is not absorbed after oral administration and is therefore administered intravenously. It is distributed through intracellular fluid, reaching adequate concentrations in the skin, bone, blister fluid and synovial fluid. Plasma protein binding is very high. Concentrations in brain tissue and cerebrospinal fluid (CSF) are inadequate. Excretion is through non-microsomal metabolism with inactive metabolites and through the kidneys by glomerular filtration...
January 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28129247/effectiveness-of-patiromer-in-the-treatment-of-hyperkalemia-in-chronic-kidney-disease-patients-with-hypertension-on-diuretics
#12
Matthew R Weir, Martha R Mayo, Dahlia Garza, Susan A Arthur, Lance Berman, David Bushinsky, Daniel J Wilson, Murray Epstein
OBJECTIVE: Recurrent hyperkalemia frequently limits use of renin-angiotensin-aldosterone system inhibitors (RAASi) in chronic kidney disease (CKD) patients with hypertension, diabetes, and/or heart failure. Patiromer is a sodium-free, nonabsorbed potassium (K)-binding polymer approved by the US Food and Drug Administration for the treatment of hyperkalemia. This post-hoc analysis of OPAL-HK examined the effectiveness and safety of patiromer in reducing serum K in hyperkalemic CKD patients on RAASi, with hypertension, receiving diuretic therapy versus those not on diuretics...
May 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28122313/fagonia-olivieri-prevented-hepatorenal-injuries-induced-with-gentamicin-in-rat
#13
Umbreen Rashid, Muhammad Rashid Khan
Gentamicin is used clinically against Gram negative bacteria because of its efficacy. However, it causes renal injuries and failure at clinical dosages on account of induced oxidative stress. Fagonia olivieri is used in kidneys, liver, alimentary canal and cardiovascular disorders in local system of medicine in Pakistan. This study evaluates the protective abilities of methanol extract of F. olivieri (FOM) against the liver and renal injuries induced with gentamicin in rat. Sprague-Dawley male rats were treated with gentamicin (80mg/kg) alone or with silymarin (50mg/kg) as standard antioxidant drug...
April 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28120731/-serious-complications-during-treatment-with-methotrexate-also-in-chronic-low-dosage-use
#14
R J Rodenburg, M J H Wijnands, P L Rensma
Methotrexate is a frequently prescribed drug and is considered to be safe at a low dosage. However, serious complications may occur during treatment. In this article we describe a 78-year-old male who used low-dose methotrexate for psoriatic arthritis. He died of multi-organ failure caused by sepsis and methotrexate intoxication as a result of deteriorating renal function. The second patient was a 56-year-old male who used low-dose methotrexate for rheumatoid arthritis. This patient developed pancytopenia and methotrexate pneumonitis during treatment with methotrexate...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28105769/renal-tubular-resistance-is-the-primary-driver-for-loop-diuretic-resistance-in-acute-heart-failure
#15
Jozine M Ter Maaten, Veena S Rao, Jennifer S Hanberg, F Perry Wilson, Lavanya Bellumkonda, Mahlet Assefa, J Sam Broughton, Julie D'Ambrosi, W H Wilson Tang, Kevin Damman, Adriaan A Voors, David H Ellison, Jeffrey M Testani
BACKGROUND: Loop diuretic resistance is a common barrier to effective decongestion in acute heart failure (AHF), and is associated with poor outcome. Specific mechanisms underlying diuretic resistance are currently unknown in contemporary AHF patients. We therefore aimed to determine the relative importance of defects in diuretic delivery vs. renal tubular response in determining diuretic response (DR) in AHF. METHODS AND RESULTS: Fifty AHF patients treated with intravenous bumetanide underwent a 6-h timed urine collection for sodium and bumetanide clearance...
January 19, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28097012/pharmacokinetics-and-pharmacodynamics-of-antibiotics-in-critically-ill-acute-kidney-injury-patients
#16
REVIEW
Welder Zamoner, Fernanda M de Freitas, Durval S S Garms, Mariele Gobo de Oliveira, André L Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and is associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administer antimicrobials in doses that achieve adequate serum levels, avoiding both overdosing and drug toxicity as well as underdosing and the risk of antibiotic resistance and higher mortality. Currently, there are no validated guidelines on antibiotic dose adjustments in septic patients with AKI...
December 2016: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28054118/-red-yeast-rice-an-unsafe-food-supplement
#17
Christian Steffen
Red yeast rice is the fermentation product of the mould Monascus ruber and is traditionally used in East Asia to dye and conserve food. Its main pharmacologically active compound, monakolin K, was isolated from red yeast rice and is used as an inhibitor of cholesterol synthesis under the INN lovastatin. Lovastatin and several other statins are marketed as drugs whereas red yeast rice is offered as a food supplement. As statins can cause severe side effects, such as muscle damage and kidney failure, the dosing and information about interactions with drugs and food is essential for the use of these products...
March 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28042550/pure-red-cell-aplasia-due-to-antibody-against-erythropoietin-in-hemodialysis-patients
#18
Maryam Rahbar, Zahra Chitsazian, Firoozeh Abdoli, Seyed-Masoud Moeini Taba, Hosein Akbari
BACKGROUND: Anemia is a common complication of chronic renal failure due to reduce erythropoietin production by kidneys. Anemia treated with recombinant human erythropoietin (rHu-EPO). Pure red cell aplasia (PRCA) due to antibody productionagainst rHu-EPO is a rare but major complication of this drug. OBJECTIVES: The aim of this study was to determine the prevalence of PRCA due to antibodies in dialysis patients with resistant anemia who received erythropoietin...
January 2017: Journal of Nephropathology
https://www.readbyqxmd.com/read/28027534/asymptomatic-hyperuricemia-is-a-strong-risk-factor-for-resistant-hypertension-in-elderly-subjects-from-general-population
#19
Alberto Mazza, Salvatore Lenti, Laura Schiavon, Alvise Del Monte, Danyelle M Townsend, Emilio Ramazzina, Domenico Rubello, Edoardo Casiglia
OBJECTIVE: In clinical practice, patient characteristics predicting resistant hypertension (RH) include higher blood pressure levels, left ventricular hypertrophy, older age, obesity, chronic kidney disease and diabetes. On the contrary little is known about the role of serum uric acid (SUA) as a risk factor for RH in subjects from general population. MATERIAL AND METHODS: 580 elderly subjects aged ≥65 years were enrolled in the Risk Of Vascular complications Impact of Genetics in Old people (ROVIGO) study...
February 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27986693/cautious-use-and-optimal-dose-of-morphine-for-relieving-malignant-pain-in-a-complex-patient-with-multiple-comorbidities
#20
Vinod Kumar, Rakesh Garg, Nishkarsh Gupta, Sachidanand Jee Bharati
Oral morphine remains the drug of choice for the management of severe pain due to cancer as per WHO ladder of analgesia. Providing adequate pain relief in palliative care settings for pain due to cancer is challenging. Options become limited in cases of associated systemic comorbidities such as renal dysfunction, hypoproteinaemia, anaemia. Patients with renal dysfunction and other comorbidities may develop drug overdose due to abnormal pharmacokinetics. Renal dysfunction affects the pharmacokinetics of morphine by altering its absorption, metabolism and clearance...
December 16, 2016: BMJ Case Reports
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