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drug dosing in kidney failure

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https://www.readbyqxmd.com/read/29299983/metabolic-enzyme-system-and-transport-pathways-in-chronic-kidney-diseases
#1
Bin Liu, Fangmei Luo, Xiuju Luo, Shaobin Duan, Zhicheng Gong, Jie Peng
BACKGROUND: Chronic kidney disease (CKD), a global public health problem, affects numerous people worldwide, and the prevalence is rising. Results from animal experiments and clinical investigations have demonstrated that drug metabolic enzymes and transporters-mediated non-renal clearance is dramatically impaired in CKD, co-respondent with the alterations in the elimination of metabolized drugs. Accumulated uremic toxins may downregulate or directly inhibit the activity and/or the expression of drug metabolic enzymes and transporters, which may result in unintended alterations of drug exposure and response in cases when drugs dose are not adjusted for the renal dysfunction...
January 3, 2018: Current Drug Metabolism
https://www.readbyqxmd.com/read/29225976/intensive-care-in-a-patient-with-toxic-epidermal-necrolysis
#2
J Wallenborn, M Fischer
Toxic epidermal necrolysis (TEN) is a serious adverse drug reaction with high lethality, which usually requires intensive-medical care. A 44-year-old man developed generalized exanthema with increasing exfoliation and mucosal involvement after taking allopurinol, ibuprofen, and etoricoxib. The clinical diagnosis of TEN was histologically confirmed. Prednisolone therapy with 3 mg/kg body weight (BW) was not able to prevent further progress to finally 80% of the body surface, and infliximab 5 mg/kg BW was given as a single dose...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29181841/epidural-therapy-for-the-treatment-of-severe-pre-eclampsia-in-non-labouring-women
#3
REVIEW
Amita Ray, Sujoy Ray
BACKGROUND: Pre-eclampsia is a pregnancy-specific multi-organ disorder, which is characterised by hypertension and multisystem organ involvement and which has significant maternal and fetal morbidity and mortality. Failure of the placental vascular remodelling and reduced uteroplacental flow form the etiopathological basis of pre-eclampsia. There are several established therapies for pre-eclampsia including antihypertensives and anticonvulsants. Most of these therapies aim at controlling the blood pressure or preventing complications of elevated blood pressure, or both...
November 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29173694/cyclophosphamide-administration-routine-in-autoimmune-rheumatic-diseases-a-review
#4
Kaian Amorim Teles, Patricia Medeiros-Souza, Francisco Aires Correa Lima, Bruno Gedeon de Araújo, Rodrigo Aires Correa Lima
Cyclophosphamide is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy, administration of cyclophosphamide, and post-chemotherapy, taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis...
November 2017: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/29169714/-idiopathic-nephrotic-syndrome
#5
O Boyer, V Baudouin, E Bérard, C Dossier, V Audard, V Guigonis, I Vrillon
Nephrotic syndrome (NS) is defined by massive proteinuria and hypoalbuminemia, with resulting hyperlipidemia and edema. The most common cause of NS in children is idiopathic nephrotic syndrome (INS), also called nephrosis. Its annual incidence has been estimated to 1-4 per 100,000 children and varies with age, race, and geography. Many agents or conditions have been reported to be associated with INS such as infectious diseases, drugs, allergy, vaccinations, and malignancies. The disease may occur during the 1st year of life, but it usually starts between the ages of 2 and 7 years...
December 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29136782/effect-of-human-umbilical-cord-blood-derived-mononuclear-cells-on-diabetic-nephropathy-in-rats
#6
Nahla E El-Ashmawy, Eman G Khedr, Hoda A El-Bahrawy, Shimaa A El-Berashy
Diabetic nephropathy (DN) is damage to the kidney which can lead to chronic renal failure, eventually requiring dialysis. Diabetes mellitus is the most common cause of adult kidney failure worldwide in the developed world. The current work was designed to elucidate the effect of mononuclear cells (MNCs) injection on reverse DN in rats exposed to streptozotocin (STZ) injection compared to metformin as a known hypoglycemic drug, 40 Male rats were divided equally into 4 groups; normal control group, diabetic control group, MNCs group were diabetic rats treated with MNCs (30×10(6) MNCs/rat once iv dose) in the tail vein of the rat, and metformin group were diabetic rats treated with metformin (100mg/kg orally daily dose) for four weeks...
November 8, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29104841/a-unique-case-of-drug-interaction-between-ticagrelor-and-statin-leading-to-acute-renal-failure
#7
Gbeminiyi Samuel, Adebayo C Atanda, Alex Onyemeh, Ahmad Awan, Oyintayo Ajiboye
Dual antiplatelet agents and high-intensity statins are frequently used in combination after myocardial infarction. Ticagrelor has the potential of causing acute kidney injury. Rosuvastatin is excreted through the kidneys and dose adjustment is needed in patients with kidney disease. When used in combination, they can potentiate the toxic effects of each other. We report a case of drug interaction between rosuvastatin and ticagrelor resulting in rhabdomyolysis and acute renal failure necessitating dialysis...
August 31, 2017: Curēus
https://www.readbyqxmd.com/read/29074099/efficacy-and-safety-of-long-acting-pasireotide-or-everolimus-alone-or-in-combination-in-patients-with-advanced-carcinoids-of-the-lung-and-thymus-luna-an-open-label-multicentre-randomised-phase-2-trial
#8
Piero Ferolla, Maria Pia Brizzi, Tim Meyer, Wasat Mansoor, Julien Mazieres, Christine Do Cao, Hervé Léna, Alfredo Berruti, Vincenzo Damiano, Wieneke Buikhuisen, Henning Grønbæk, Catherine Lombard-Bohas, Christian Grohé, Vincenzo Minotti, Marcello Tiseo, Javier De Castro, Nicholas Reed, Gabriella Gislimberti, Neha Singh, Miona Stankovic, Kjell Öberg, Eric Baudin
BACKGROUND: There are no data from prospective studies focused exclusively on patients with advanced lung and thymic carcinoids. We aimed to assess the efficacy and safety of long-acting pasireotide and everolimus, administered alone or in combination, in patients with advanced carcinoids of the lung or thymus. METHODS: LUNA was a prospective, multicentre, randomised, open-label, phase 2 trial of adult patients (aged >18 years) with advanced (unresectable or metastatic), well differentiated carcinoid tumours of the lung or thymus, with radiological progression within 12 months before randomisation, and a WHO performance status of 0-2...
October 23, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/29038262/severe-infusion-related-adverse-events-and-renal-failure-in-patients-receiving-high-dose-intravenous-polymyxin-b
#9
Josiane F John, Diego R Falci, Maria Helena Rigatto, Renata D Oliveira, Thaysa G Kremer, Alexandre P Zavascki
Very high doses of polymyxin B (PMB) have been addressed in in vitro experiments against carbapenem-resistant Gram-negative bacilli as a strategy to improve bacterial killing and suppress resistance emergence. However, the toxicities of very high doses in patients are unknown. This is a retrospective cohort study assessing patients receiving >3mg/kg/day or a total dose ≥250mg/day of PMB. The main outcomes were severe infusion-related adverse event according to Common Terminology Criteria for Adverse Criteria and renal failure category of RIFLE criteria for acute kidney injury (AKI) during treatment...
October 16, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29032332/long-term-treatment-with-chaethomellic-acid-a-reduces-glomerulosclerosis-and-arteriolosclerosis-in-a-rat-model-of-chronic-kidney-disease
#10
António Nogueira, Helena Vala, Carmen Vasconcelos-Nóbrega, Ana Isabel Faustino-Rocha, Carlos André Pires, Aura Colaço, Paula Alexandra Oliveira, Maria João Pires
The high prevalence of end-stage renal disease emphasizes the failure to provide therapies to effectively prevent and/or reverse renal fibrosis. Therefore, the aim of this study was to evaluate the effect of long-term treatment with chaethomellic acid A (CAA), which selectively blocks Ha-Ras farnesylation, on renal mass reduction-induced renal fibrosis. Male Wistar rats were sham-operated (SO) or subjected to 5/6 renal mass reduction (RMR). One week after surgery, rats were placed in four experimental groups: SO:SO rats without treatment (n=13); SO+CAA: SO rats treated with CAA (n=13); RMR:RMR rats without treatment (n=14); and RMR+CAA:RMR rats treated with CAA (n=13)...
October 12, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29027615/assessment-of-the-role-of-everolimus-therapy-in-patients-with-renal-cell-carcinoma-based-on-daily-routine-and-recent-research-results
#11
Anikó Maráz, András Csejtei, Judit Kocsis, Miklós Szűcs, Zsuzsanna Kahán, György Bodoky, Magdolna Dank, László Mangel, János Révész, Zoltán Varga, Lajos Géczi
Everolimus is indicated for adults with metastatic renal cell carcinoma (mRCC) after failure of vascular endothelial growth factor receptor-tyrosine kinase inhibitors (TKI). Currently, the therapeutic applicability of EVE has been changing. Multicenter evaluation of efficacy and safety of everolimus in daily routine and definition of patient characteristics with favorable outcome. Data of 165 patients from 9 oncology institutes in Hungary were analyzed retrospectively. Everolimus therapy was used after one TKI in 10 mg starting dose...
October 13, 2017: Pathology Oncology Research: POR
https://www.readbyqxmd.com/read/29023830/drug-management-in-acute-kidney-disease-report-of-the-acute-disease-quality-initiative-xvi-meeting
#12
Marlies Ostermann, Lakhmir S Chawla, Lui G Forni, Sandra L Kane-Gill, John A Kellum, Jay Koyner, Patrick T Murray, Claudio Ronco, Stuart L Goldstein
AIMS: To summarize and extend the main conclusions and recommendations relevant to drug management during acute kidney disease (AKD) as agreed at the 16th Acute Disease Quality Initiative (ADQI) consensus conference. METHODS: Using a modified Delphi method to achieve consensus, experts attending the 16th ADQI consensus conference reviewed and appraised the existing literature on drug management during AKD and identified recommendations for clinical practice and future research...
October 11, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28984487/dapagliflozin-and-saxagliptin-tablets-for-adults-with-type-2-diabetes
#13
André J Scheen
Saxagliptin (a dipeptidyl peptidase-4 inhibitor, DPP-4i) and dapagliflozin (a sodium-glucose cotransporter type 2 inhibitor, SGLT2i) improve glucose control in type 2 diabetes (T2D) through different potentially complementary mechanisms, thus offering the opportunity for a combined therapy. Area covered: The characteristics of the saxagliptin/dapagliflozin combination are analysed, focusing on: 1) pharmacokinetic and pharmacodynamic properties; 2) efficacy and safety in phase III trials with concurrent and sequential add-on therapy; and 3) potential use in clinical practice, including in special populations (cardiovascular disease, heart failure, chronic kidney disease, elderly)...
October 18, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28974245/dose-escalation-study-of-intravenous-and-intra-arterial-n-acetylcysteine-for-the-prevention-of-oto-and-nephrotoxicity-of-cisplatin-with-a-contrast-induced-nephropathy-model-in-patients-with-renal-insufficiency
#14
Edit Dósa, Krisztina Heltai, Tamás Radovits, Gabriella Molnár, Judit Kapocsi, Béla Merkely, Rongwei Fu, Nancy D Doolittle, Gerda B Tóth, Zachary Urdang, Edward A Neuwelt
BACKGROUND: Cisplatin neuro-, oto-, and nephrotoxicity are major problems in children with malignant tumors, including medulloblastoma, negatively impacting educational achievement, socioemotional development, and overall quality of life. The blood-labyrinth barrier is somewhat permeable to cisplatin, and sensory hair cells and cochlear supporting cells are highly sensitive to this toxic drug. Several chemoprotective agents such as N-acetylcysteine (NAC) were utilized experimentally to avoid these potentially serious and life-long side effects, although no clinical phase I trial was performed before...
October 3, 2017: Fluids and Barriers of the CNS
https://www.readbyqxmd.com/read/28870161/chronic-dialysis-nat2-polymorphisms-and-the-risk-of-isoniazid-induced-encephalopathy-case-report-and-literature-review
#15
Stefan Matei Constantinescu, Benoit Buysschaert, Vincent Haufroid, Franck Broly, Michel Jadoul, Johann Morelle
BACKGROUND: Isoniazid is the most widely used anti-tuberculosis agent, yet it may lead to life-threatening complications. CASE PRESENTATION: Here we report the case of a chronic hemodialysis patient who developed severe encephalopathy after the start of isoniazid. Blood levels of isoniazid were elevated, and acetyl-isoniazid over isoniazid ratio was decreased 3 h after intake of the medication, suggesting that a slow acetylator phenotype may have contributed to drug toxicity, in addition to pyridoxal phosphate removal by dialysis...
September 4, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28779862/neurological-complications-of-renal-disease
#16
Jorge H Baluarte
Neurological manifestations related to electrolyte disorders, drug toxicity, and uremia are common in chronic kidney disease (CKD). Seizures and coma are frequent complications of acute renal insufficiency (uremia), whereas peripheral neuropathy and encephalopathy, observed in progressive uremia, are terminal events. Failure to excrete metabolic products causes their accumulation and can lead to severe intoxication. Clinically, the signs and symptoms of uremia can vary widely, depending on the biological characteristics of the patient, the specific type of renal disease, and the time of the uremic intoxication...
February 2017: Seminars in Pediatric Neurology
https://www.readbyqxmd.com/read/28774729/-thrombotic-microangiopathy-and-cancer
#17
Rania Kheder El-Fekih, Clément Deltombe, Hassan Izzedine
Thrombotic microangiopathy (TMA) is a group of disorders characterized by mechanical hemolytic anemia with thrombocytopenia and an ischemic organic lesion of variable and potentially fatal importance affecting mostly the kidneys and the brain with histologically a disseminated and occlusive microvasculopathy. The incidence of TMA represents 15% of acute kidney failure in oncological setting, largely due to the introduction of anti-angiogenic agents over the past decade. It may be more rarely related to cancer itself...
July 31, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28770975/paracetamol-acetaminophen-for-chronic-non-cancer-pain-in-children-and-adolescents
#18
REVIEW
Tess E Cooper, Emma Fisher, Brian Anderson, Nick Mr Wilkinson, David G Williams, Christopher Eccleston
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past, pain was largely dismissed and was frequently left untreated, views on children's pain have changed over time, and relief of pain is now seen as important...
August 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28755953/kidney-toxicity-related-to-herbs-and-dietary-supplements-online-table-of-case-reports-part-3-of-5-series
#19
REVIEW
Amy Christine Brown
BACKGROUND: No tabular summary of potentially life-threatening, kidney-toxic dietary supplements (DS; includes herbs) based on PubMed case reports is currently available online and continually updated to forewarn United States consumers, clinicians, and companies manufacturing DS. The purpose of this review was to create an online research summary table of kidney toxicity case reports related to DS. METHODS: Documented PubMed case reports (1966 to May 2016, and cross-referencing) of DS appearing to contribute to kidney toxicity were listed in "DS Toxic Tables...
September 2017: Food and Chemical Toxicology
https://www.readbyqxmd.com/read/28745686/-effects-of-keto-amino-acids-and-a-low-protein-diet-on-the-nutritional-status-of-patients-with-stages-3b-4-chronic-kidney-disease
#20
S Yu Milovanova, Yu S Milovanov, M V Taranova, I A Dobrosmyslov
AIM: To evaluate the efficacy of keto/amino acids in maintaining protein balance and preventing mineral metabolic disturbances and the development of uremic hyperparathyroidism in the long-term use of a low-protein diet (LPD) in patients with Stages 3B-4 chronic kidney disease (CKD). SUBJECTS AND METHODS: Ninety patients with CKD caused by chronic latent glomerulonephritis in 65 patients and chronic tubulointerstitial nephritis of various etiologies (gout, drug-induced, and infection) in 25 were examined...
2017: Terapevticheskiĭ Arkhiv
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