Читать книгу Clinical Pharmacology and Therapeutics - Группа авторов - Страница 60

Drug therapy can result in deterioration of the clinical condition in the following ways:

1 By further impairing renal function. In patients with renal failure, it is clearly advisable to avoid drugs that are known to be nephrotoxic and for which alternatives are available. Examples include aminoglycosides, amphotericin, cisplatin, gold, mesalazine, non‐steroidal anti‐inflammatories, penicillamine and vancomycin

2 By causing fluid retention. Fluid balance is a major problem in the more severe forms of renal failure. Drugs that cause fluid retention should therefore be avoided, e.g. carbenoxolone and non‐steroidal anti‐inflammatory drugs (NSAIDs) such as indometacin (indomethacin)

3 By increasing the degree of uraemia. Tetracyclines, except doxycycline, have an anti‐anabolic effect and should be avoided