Diuretics
NSAIDs
ACEI
(These three make up the "triple whammy")
Vancomycin
Aminoglycosides (eg gentamycin)
Contrast

List six of the most common classes of medications that are nephrotoxic?

Diuretics NSAIDs ACEI (These three ________

Medication management in AKI

Diuretics
NSAIDs
ACEI
(These three make up the &quot;triple whammy&quot;)
Vancomycin
Aminoglycosides (eg gentamycin)
Contrast

Enoxaparin
Opioids
Antibiotics - penicillins, vancomycin, trimethoprim
Neuropathic agents
Atenolol
Hypoglycaemic agents

List some very commonly used medications that are renally excreted and risky in renal impairment

What do ACE inhibitors do to the renal arterioles?

Withhold perindopril (consider another antihypertensive like a CCB)
Withhold metformin (consider temporary insulin)
Dose reduce digoxin (and monitor levels)
Cease meloxicam

Ron has AKI, this is his drug chart. What would you change?
Perindopril 5mg
Atorvastatin 40
Aspirin 100mg
Metformin 1g bd
Digoxin 125 microg daily
Diltiazem CR 240mg daily
Meloxicam PRN

Enoxaparin 20mg daily (and monitor anti-Xa)
Atenolol 25mg daily (and monitor HR)
Frusemide - increase or reduce as per fluid status
Levetiracetam - reduce to 250-500mg bd
Oxycodone 5mg q4H PRN - or could consider fentanyl

Lakshmi has AKI (eGFR=20), this is her drug chart. What would you change?
Enoxaparin 40mg daily
Atorvastatin 40mg nocte
Atenolol 50mg bd
Frusemide 40mg po bd
Paracetamol SR 1330 tds
Levetiracetam 1g bd
Clopidogrel 75mg daily
Aspirin 100mg daily
Morphine 2mg s/cut PRN

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Medication management in AKI Flashcards

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