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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Measuring RAN Peptide Toxicity in C. elegans
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Toxicity in Patients.

Jason M Pogue1, Vincent H Tam2

  • 1Department of Pharmacy Services, Sinai-Grace Hospital, Detroit Medical Center, Detroit, MI, USA. jpogue@dmc.org.

Advances in Experimental Medicine and Biology
|August 1, 2019
PubMed
Summary
This summary is machine-generated.

Polymyxin antibiotics can cause significant kidney damage (nephrotoxicity) in 30-60% of patients. This review details risk factors, including dose and serum levels, for this common adverse event.

Keywords:
ColistimethateColistinGram-negative bacteriaNephrotoxicityNon-renal toxicitiesPolymyxin B

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Area of Science:

  • Pharmacology
  • Nephrology
  • Infectious Diseases

Background:

  • Polymyxins are crucial last-resort antibiotics for multidrug-resistant Gram-negative infections.
  • Nephrotoxicity is a major dose-limiting toxicity, restricting their clinical use.
  • Understanding nephrotoxicity is vital for optimizing patient care and antibiotic stewardship.

Purpose of the Study:

  • To comprehensively review polymyxin-induced nephrotoxicity.
  • To identify and analyze risk factors associated with this adverse event.
  • To discuss the impact of dosing, serum concentrations, and drug selection on kidney injury.

Main Methods:

  • Literature review and analysis of existing studies on polymyxin nephrotoxicity.
  • Assessment of clinical data regarding incidence and risk factors.
  • Examination of pharmacokinetic and pharmacodynamic principles related to toxicity.

Main Results:

  • Nephrotoxicity affects 30-60% of patients receiving systemic polymyxins.
  • Key risk factors include higher doses, elevated serum concentrations, and specific polymyxin agents.
  • Less common but significant adverse events associated with polymyxins are also identified.

Conclusions:

  • Polymyxin nephrotoxicity is a prevalent and serious concern.
  • Careful patient selection, dose optimization, and therapeutic drug monitoring are essential.
  • Further research into mitigating polymyxin toxicity is warranted to preserve their clinical utility.