Open AccessDrug-interaction-induced hemodynamically mediated acute renal failure in postsurgical patient
Author(s) -
Arup Kumar Misra,
Satish E Bahekar,
Ranjana S Kale,
Sushil Kumar Varma
Publication year - 2014
Publication title -
medical journal of dr. d y patil university/medical journal of dr. d.y. patil university
Language(s) - English
Resource type - Journals
eISSN - 2278-7119
pISSN - 0975-2870
DOI - 10.4103/0975-2870.128983
Subject(s) - medicine , diclofenac , nephrotoxicity , drug , ceftriaxone , drug interaction , pharmacology , regimen , acute kidney injury , anesthesia , kidney , antibiotics , microbiology and biotechnology , biology
Acute renal failure is a life threatening condition. Nonsteroidal antiinflammatory drugs (NSAIDs) and cephalosporins are widely used postoperative drugs. NSAID-induced acute renal failure has been reported in the past. In this case, drug interaction and decompensated state of the patient precipitate the condition. NSAIDs inhibit prostaglandins synthesis and thus aggravate ischemia to the kidney that is already facing volume crisis due to surgery. Due to renal dysfunction, plasma ceftriaxone level increases due to decrease clearance and it also acts as nephrotoxic by unknown mechanism. On the other hand, ceftriaxone on its interaction with diclofenac for renal tubular clearance also increases the level of diclofenac and thus further aggravate the ischemia. It is a reversible condition with excluding diclofenac from the treatment regimen and giving adequate hydration to the patient. This highlights the importance of hydration and knowledge of drugs interactions in a postsurgical patient