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Related Experiment Videos

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
PubMed
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.

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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.

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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.