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06-05-2009, 09:55 AM
Drug induced nephropathy


Acute renal F.
ž pre renal : diuretics hypovolemia.(loop diutertic)
ž Renal A. T. N. aminoglycosides
Interstitial nephritis methicillin
ž post renal: anticoag. (clots of blood), crystalluria by
sulfa
C. R. failure : analgesic nephropathy.
Nephrotic $ : gold, tridione, NSAID, capoten,
penicillamine.
Acute G.N.(Nephretic) : Rifampicin, albumin infusion.
Tubular defects outdated tetracycline (fanconi $)
lithium D.I.
6-Acute interstitial nephritis see before.
7-chronic interstitial nephritis see before.


Analgesic nephropathy
(2-3 k gm)


Aspirin
Phenacetine or paracetamol

Path: It’s a chronic intersitial nephritis.
Both 1,2 are transformed into toxic metabolites

cellular toxicity due to

glutathione Anti P.G. uncoupling
depletion effect (esp. Aspirin) of O * P
esp. paracetamol
―― blood supply
C/P: CRF.

ttt: as CRF.




Cyclosporine= Sandimmun

It is a potent immuno suppressive agent which prolongs survival of transplants involving skin, kid, liver, heart, pancreas & B.M.

Mech.
It Q release of interleukin 2 so Q release of lymphokines without affection or the rapidly dividing cells of B.M.

Contraindication
Known hypersensitivity.

Side effects
-hypertrichosis.
-Hepatotoxic.
-Nephrotoxic.
-G I T upset.

Preparation

( Sandimmun oral solution)

Source: Internal Medicine Book of Dr.Osama Mahmoud (Ain Shams University)