domingo, 17 de febrero de 2013

FÁRMACOS EN INSUFICIENCIA RENAL

La Asociación Australiana de Médicos de Familia (Australian Family Physician) ha publicado una revisión de fármacos a revisar y a utilizar con precaución en pacientes ancianos con insuficiencia renal crónica: Prescribing for older people with chronic renal impairment

Table 1. Medicines that may accumulate and require renal function monitoring*
Analgesics Genitourinary Anticoagulant Endocrine
Codeine Solifenacin# Dabigatran Glibenclamide
Hydromorphone Sildenafil Enoxaparin Glimepiride
Morphine Tadalafil Rivaroxaban Gliptins (saxagliptin, sitagliptin, vildagliptin)
Oxycodone Tolterodine# Metformin
Tramadol Vardenafil
Neurological Psychotropic Cardiovascular Gastrointestinal
Baclofen Acamprosate ACEIsH2-antagonists
Gabapentin Amisulpride ARBs
Galantamine Benzodiazepines Atenolol Musculoskeletal
Levetiracetam Bupropion Bisoprolol Allopurinol
Memantine Desvenlafaxine Digoxin Bisphosphonates
Methysergide Duloxetine Fenofibrate Colchicine
Pramipexole Lithium Strontium ranelate
Pregabalin Paliperidone Teriparatide
Topiramate Reboxetine
Varenicline Venlafaxine
* This list does not include antibiotic, antifungal or antiviral medicines, or those medicines predominately used in the hospital setting
# Not available on the PBS/RPBS
† Use in renal impairment may increase the risk of hyperkalaemia; monitor potassium levels
Reproduced with permission Veterans’ MATES Therapeutic Brief 30. Available at
www.veteransmates.net.au

Table 2. Medicines associated with renal func- tion decline or nephrotoxicity
ACEIs*
ARBs*
Bisphosphonates Frusemide# H2-antagonists NSAIDs/COX-2 inhibitors Penicillamine
Proton pump inhibitors
* Use in renal impairment may increase the risk of hyperkalaemia; monitor potassium levels
# Higher doses are often required in renal impairment and may cause decline in renal function; monitor electrolytes
† Acute interstitial nephritis is a very rare adverse effect of proton-pump inhibitors
Reproduced with permission Veterans’ MATES Therapeutic Brief 30. Available at www.veteransmates. net.au

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