Medications save and improve lives, but it can be easy to overlook their risks and side effects, especially if you don't think they apply to you. Twenty-six million Americans have chronic kidney disease and most don't know it. If you don't know how well your kidneys are working, you may not realize that certain medications could be damaging your kidneys and other parts of your body. Both prescription and over-the-counter medications are filtered by the kidneys. This means that your kidneys degrade and remove medications from the body. When your kidneys aren't working properly, medications can build up and cause you harm. It's important to get your kidneys checked and to work with your doctor to make any adjustments to your medication regimen, such as dosing changes or substitutions. The NICE British National Formulary (BNF) and British National Formulary for Children (BNFc) sites are only available to users in the UK, Crown Dependencies and British Overseas Territories. If you believe you are seeing this page in error please contact us.
Amoxicillin is a penicillin antibiotic used to treat bacterial infections, including bronchitis, pneumonia, and infections of the ear, nose, throat, skin, and urinary tract. Though it can be highly effective in treating bacterial infections, it also comes with a list of potential side effects even in those who aren’t allergic to it. Allergies aren’t always the reason for a negative reaction to a drug. Though it may seem like an allergic reaction, it is really a nonallergic adverse reaction. The most common causes of nonallergic adverse reactions are anticonvulsants, aspirin and NSAIDS, vaccines, diabetes meds, and chemotherapeutic agents. Mild allergic reactions include skin rash, itching, and hives. Mild allergic reactions aren’t too worrisome on their own but should be observed in case symptoms worsen. Mild symptoms can be treated with antihistamines and hydrocortisone. Your kidneys get rid of waste in your body and help you hold on to the right amount of fluid. They also send out hormones that keep your blood pressure steady, and they play a role in making red blood cells. They even make a form of vitamin D that’s good for your bones. Some medications can make those things hard for your kidneys to do and keep them from working the way they should. For example, some can make crystals that don't break down and can block your urine flow. Others have substances that can damage certain kidney cells when they try to filter them out. Some people also have allergic reactions to antibiotics that can affect their kidneys. All these things are more likely to happen if you take antibiotics for a long time or your dose is very high.
MUNAR, PHARMD, BCPS, and HARLEEN SINGH, Pharm D, Oregon State University College of Pharmacy, Portland, Oregon Am Fam Physician. This article exemplifies the AAFP 2007 Annual Clinical Focus on management of chronic illness. Chronic kidney disease affects renal drug elimination and other pharmacokinetic processes involved in drug disposition (e.g., absorption, drug distribution, nonrenal clearance [metabolism]). Drug dosing errors are common in patients with renal impairment and can cause adverse effects and poor outcomes. Dosages of drugs cleared renally should be adjusted according to creatinine clearance or glomerular filtration rate and should be calculated using online or electronic calculators. Recommended methods for maintenance dosing adjustments are dose reductions, lengthening the dosing interval, or both. Physicians should be familiar with commonly used medications that require dosage adjustments. Resources are available to assist in dosing decisions for patients with chronic kidney disease. Because of its favourable pharmacokinetics and antimicrobial efficacy, amoxicillin is widely used for perioperative antibiotic prophylaxis. We report here three cases of acute renal failure following the administration of amoxicillin during epilepsy surgery. A 50-year-old Caucasian woman suffering from temporal lobe epilepsy refractory to antiepileptic drugs (AED) from the age of 2 years was admitted for partial left temporal lobe resection after extensive evaluation and non-invasive monitoring for determination of her epileptogenic focus. She was in good health without previous or concomitant diseases. Her medication consisted of carbamazepine 600 mg b.d. Laboratory work including creatinine (0.7 mg/dl) and urea (28 mg/dl) revealed no pathological findings. For perioperative antibiotic cover she received 4.4 g amoxicillin/clavulanic acid intravenously.
Dosing Modifications. Renal impairment Patients with impaired renal function do not generally require dose reduction unless impairment is severe; do not. Base dose on amoxicillin component. Due to clavulanic acid component two 250mg tabs are not equivalent to one 500mg tab; also, the 250mg tab and the.