Medication Nephrotoxic Effects - CKD Pathway

1 The Chronic Kidney Disease (CKD) Clinical Pathway is a resource for primary care providers to aid in the diagnosis, medical management, and referral of adults with drugs that may have Nephrotoxic effectsOtherMedicationNephrotoxic EffectsAcetaminophen, aspirinChronic interstitial nephritisAllopurinol (Zyloprim)Acute interstitial nephritisAmitriptyline (Elavil), doxepin (Zonalon), fluoxetine (Prozac)RhabdomyolysisBenzodiazepinesRha bdomyolysisClopidogrel (Plavix), ticlopidine (Ticlid)Thrombotic microangiopathyDiphenhydramine (Benadryl), doxylamine (Unisom)RhabdomyolysisGold therapyGlomerulonephritisHaloperidol (Haldol)RhabdomyolysisPamidronate (Aredia)GlomerulonephritisPhenytoin (Dilantin)Acute interstitial nephritisRanitidine (Zantac)Acute interstitial nephritisStatinsRhabdomyolysisTriamteren eCrystal nephropathyZoledronate (Zometa)Acute kidney injury (AKI)The Chronic Kidney Disease (CKD) Clinical Pathway is a resource for primary care providers to aid in the diagnosis, medical management, and referral of adults with drugs that may have Nephrotoxic effectsOtherAntimicrobialsMedicationNeph rotoxic EffectsAcyclovir (Zovirax) Acute interstitial nephritis, crystal nephropathyAmphotericin B (Fungizone.)

2 Deoxycholic acid formulation more so than the lipid formulation)Acute kidney injury (AKI)Beta lactams (penicillins, cephalosporins)Acute interstitial nephritis, glomerulonephritis (ampicillin, penicillin)Foscarnet (Foscavir)Crystal nephropathy, acute kidney injury (AKI)Ganciclovir (Cytovene)Crystal nephropathyPentamidine (Pentam)Acute kidney injury (AKI)Quinine (Qualaquin)Thrombotic microangiopathyQuinolonesAcute interstitial nephritis, crystal nephropathy (ciprofloxacin [Cipro]), acute kidney injury (AKI), granulomatous interstitial nephritis At least a two-fold increase in risk of AKI (ciprofloxacin>moxifloxacin>levofloxacin ) Association of increased risk of AKI when quinolone combined with renin-angiotensin-system blockersRifampin (Rifadin)Acute interstitial nephritisSulfonamidesAcute interstitial nephritis, crystal nephropathyVancomycin (Vancocin) Acute interstitial nephritisAntiretrovirals.

3 Adefovir (Hepsera), cidofovir (Vistide), tenofovir (Viread)Acute kidney injury (AKI)Indinavir (Crixivan)Acute interstitial nephritis, crystal nephropathy The Chronic Kidney Disease (CKD) Clinical Pathway is a resource for primary care providers to aid in the diagnosis, medical management, and referral of adults with drugs that may have Nephrotoxic effectsOtherChemotherapeuticsMedicationN ephrotoxic EffectsCarmustine (Gliadel), semustine (investigational)Chronic interstitial nephritisCisplatin (Platinol)Chronic interstitial nephritis, acute kidney injury (AKI)Interferon-alfa (Intron A)GlomerulonephritisMethotrexateCrystal nephropathyMitomycin-C (Mutamycin)Thrombotic microangiopathyDrugs of abuseMedicationNephrotoxic EffectsCocaine, heroin, ketamine (Ketalar), methadone, methamphetamineRhabdomyolysisHerbalsMedi cationNephrotoxic EffectsChinese herbals with aristocholic acid Chronic interstitial nephritisProton pump inhibitorsMedicationNephrotoxic EffectsLansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix)Acute interstitial nephritis