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Several drugs with a narrow therapeutic window, such as warfarin and nifedipine, are metabolized by CYP2C9. [7] Nafcillin contains salts added as stability media. These added salts could cause edema or fluid accumulation. It would be prudent to avoid this medication if there were a concern for a congestive heart failure or kidney disease.
The use of nitrofurantoin is contraindicated in patients with an estimated GFR of less than 30 mL/min/1.73m 2 as drug accumulation can lead to increased side effects and impaired recovery of the urinary tract, increasing the risk of treatment failure. [29] The use of TMP/SMX also raises concerns in patients with kidney disease.
Severe liver failure, marked liver parenchymal damage, or jaundice. Serious haematological disorders and porphyria (due to the sulfonamide component of the preparation). Severe chronic kidney disease (CrCl <15 ml/min) where repeated measurements of the plasma concentration cannot be performed
Effective against aerobic bacteria (not obligate/facultative anaerobes) and tularemia. All aminoglycosides are ineffective when taken orally as the stomach will digest the drug before it goes into the bloodstream. However aminoglycosides are effective in Intravenous, intramuscular and topical forms. Hearing loss; Vertigo; Kidney damage
It does not easily cross the blood–brain barrier or enter ocular tissue. [8] While the half-life of amikacin is normally two hours, it is 50 hours in those with end-stage renal disease. [16] The majority (95%) of amikacin from an intramuscular or intravenous dose is secreted unchanged via glomerular filtration and into the urine within 24 hours.
Imipenem is the active antibiotic agent and works by interfering with their ability to form cell walls, so the bacteria break up and die. Imipenem is rapidly degraded by the renal enzyme dehydropeptidase if administered alone (making it less effective); the metabolites can cause kidney damage. [9]
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