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 ACEIs† H2-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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