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Hepatic and renal dysfunction following nafcillin administration.
M R Lestico1, K E Vick, C M Hetsko
1St. Marys Hospital Medical Center, Madison, WI 53715.
The Annals of Pharmacotherapy
|July 1, 1992
Summary
Nafcillin, a penicillinase-resistant penicillin, may cause liver and kidney damage in adults, particularly at high doses. Monitoring hepatic and renal function is advised during nafcillin therapy.
Area of Science:
- Pharmacology
- Hepatology
- Nephrology
Background:
- Nafcillin is a commonly prescribed penicillinase-resistant penicillin.
- Adverse hepatic and renal events associated with nafcillin have not been widely documented.
Observation:
- Four adult cases of combined hepatic and renal toxicity were observed following nafcillin administration.
- These toxicities emerged within 72 hours of initiating nafcillin therapy, especially at doses exceeding 9 g/24 hours.
Findings:
- Elevated blood urea nitrogen, creatinine, total bilirubin, and lactate dehydrogenase indicated renal and hepatic dysfunction.
- Laboratory values normalized upon discontinuation of nafcillin.
- The precise mechanisms and patient risk factors for these toxicities remain unclear.
Implications:
- Clinicians should exercise caution when prescribing nafcillin.
- Pre-treatment and early (within 72 hours) monitoring of liver and kidney function tests are recommended.
- Discontinuation of nafcillin should be considered if toxicity is detected.