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Related Concept Videos

Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
Renal Drug Excretion: Overview01:15

Renal Drug Excretion: Overview

As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
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Amoxicillin renal toxicity: how often does it occur?

Rita Mrvos1, Tara L Pummer, Edward P Krenzelok

  • 1Pittsburgh Poison Center, University of Pittsburgh Medical Center, PA 15213, USA. mrvosr@upmc.edu

Pediatric Emergency Care
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Renal symptoms from amoxicillin ingestion in young children are rare, occurring in only 0.03% of cases. The study found no clear link between the dose ingested and the development of these rare adverse events.

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Area of Science:

  • Pediatric Toxicology
  • Pharmacovigilance
  • Antibiotic Safety

Background:

  • Amoxicillin is a widely prescribed antibiotic for children.
  • Renal adverse effects are a potential concern with antibiotic use.
  • Data on amoxicillin-induced renal symptoms in young children is limited.

Purpose of the Study:

  • To investigate the incidence of renal symptoms following amoxicillin exposure in children under six years of age.
  • To analyze data from the National Poison Data System (NPDS) for amoxicillin ingestions.

Main Methods:

  • Retrospective review of amoxicillin ingestions in children younger than 6 years reported to the NPDS (2004-2008).
  • Analysis included patient demographics, management site, outcome, symptoms, and ingested amount.
  • Descriptive statistics were used to characterize the data.

Main Results:

  • 14,717 cases were identified; 5 patients (0.03%) experienced related renal symptoms.
  • In cases with documented amount and weight, the median ingestion was 82.6 mg/kg.
  • Of those with known outcomes, most had no effect (81.9%), with few experiencing minor (16.0%) or moderate (2.1%) symptoms.

Conclusions:

  • Renal toxicity associated with amoxicillin ingestion in young children is uncommon.
  • The available data suggests that renal symptoms are not strongly dose-dependent.