Which aminoglycoside is most nephrotoxic?

Which aminoglycoside is most nephrotoxic?

Choice of aminoglycoside The following rank order of nephrotoxicity has been reported, from most toxic to least toxic: neomycin > gentamicin ≥ tobramycin ≥ amikacin ≥ netilmicin > streptomycin [1].

How do aminoglycosides damage kidneys?

Aminoglycoside Nephrotoxicity In addition to their direct effect on cells, aminoglycosides cause renal vasoconstriction. The 2 critical factors in the development of acute kidney injury (AKI) secondary to aminoglycoside nephrotoxicity are dosing and duration of therapy.

What drugs produce significant nephrotoxicity?

Drugs Associated with Nephrotoxicity

Drug class/drug(s) Pathophysiologic mechanism of renal injury
Haloperidol (Haldol) Rhabdomyolysis
Pamidronate (Aredia) Glomerulonephritis
Phenytoin (Dilantin) Acute interstitial nephritis
Quinine (Qualaquin) Thrombotic microangiopathy

Which antibiotic can cause nephrotoxicity?

The potentially nephrotoxic antibiotics in current clinical use are neomycin, kanamycin, paromomycin, bacitracin, the polymyxins (polymyxin B, and colistin), and amphotericin B.

What is the most toxic aminoglycoside?

However, the aminoglycosides displayed marked differences in the threshold dose required to produce toxic reactions, permitting the following ordering of toxicity: (most toxic) gentamicin greater than netilmicin = tobramycin greater than amikacin = kanamycin (least toxic).

Are all aminoglycosides nephrotoxic?

Aminoglycosides are nephrotoxic because a small but sizable proportion of the administered dose (≈5%) is retained in the epithelial cells lining the S1 and S2 segments of the proximal tubules (135) after glomerular filtration (30).

Why are the aminoglycosides contraindicated in patients with kidney failure?

Effect of renal dysfunction Patients with decreased GFRs may have impaired cellular uptake of the drug. Therefore, patients with underlying kidney disease may not be able to attain adequate drug concentrations in the renal cortex to exert aminoglycoside-induced toxicity.

How aminoglycoside antibiotics cause Aki?

Acute kidney injury is a relatively common complication of therapy with the aminoglycoside antibiotics, with a rise in the plasma creatinine concentration of more than 0.5 to 1 mg/dL (44 to 88 micromol/L) or 50 percent increase in plasma creatinine concentration from baseline occurring in 10 to 20 percent of patients [ …

Which drug is associated with renal toxicity?

Table 1

Medication Drug category Renal toxicity
Acyclovir Antiviral Acute interstitial nephritis, crystal nephropathy
Allopurinol Hypouricemic agent Acute interstitial nephritis
Aspirin Non-narcotic analgesic Chronic interstitial nephritis
Amitriptyline Antidepressant Rhabdomyolysis

Which of the following drugs can lead to kidney damage?

Illegal Drugs Most street drugs, including heroin, cocaine and ecstasy can cause high blood pressure, stroke, heart failure and even death, in some cases from only one use. Cocaine, heroin and amphetamines also can cause kidney damage.

Which antibiotics cause nephrotoxicity and ototoxicity?

The aminoglycoside antibiotic gentamicin can cause both ototoxicity and nephrotoxicity, the severity of which varies with circadian time of daily treatment.

Which antibiotic is least nephrotoxic?

Among these treatment groups, tobramycin was the least nephrotoxic of the aminoglycosides.

What are the main features of nephrotoxicity in aminoglycosides?

GENERAL FEATURES OF AMINOGLYCOSIDE NEPHROTOXICITY Nephrotoxicity induced by aminoglycosides manifests clinically as nonoliguric renal failure, with a slow rise in serum creatinine and a hypoosmolar urinary output developing after several days of treatment.

What are the risk factors for drug induced nephrotoxicity?

Some patient-related risk factors for drug-induced nephrotoxicity are age older than 60 years, underlying renal insufficiency (e.g., glomerular filtration rate of less than 60 mL per minute per 1.73 m 2 ), volume depletion, diabetes, heart failure, and sepsis.

What causes nephrotoxicity in the proximal tubule?

These drugs cause nephrotoxicity, which particularly affects the proximal tubule epithelial cells due to selective endocytosis and accumulation of aminoglycosides via the multi-ligand receptor megalin.

Can a drug induced nephrotoxicity be reversible?

Monitor renal function and vital signs after starting or increasing the dose of drugs associated with nephrotoxicity, especially when used chronically. Drug-induced renal impairment is generally reversible, provided the nephrotoxicity is recognized early and the offending medication is discontinued.