| Drugs to avoid with CKD | Any drug that is nephrotoxic should be avoided –
e.g. gentamicin used for endocarditis treatment; tetracyclines other than doxycycline should be avoided
Other drugs may require dose reduction –
e.g.aciclovir, amoxicillin, ampicillin, cefalexin and erythromycin
Remember renal transplants = immunosuppression (ciclosporin) – caution with concurrent drugs
Drugs used in dental sedation should be used with extreme care as a greater effect than normal may be produced |
| Warfarin interacts with | interaction of non-steroidal anti-inflammatory drugs (NSAIDs), carbamazapine, azole antifungals, metronidazole and macrolide antibiotics with warfarin. |
| statins and azoles and clarithro | incidence of myopathy after prescribing azoles and clarithromycin in those taking statins. |
| Metro vs amoxa | No amoxa if penicillin allergy, metro- alcohol indication. Amox safer if pregnant |
| Signs of systemic infection | § Malaise (tiredness)
§ Myalgia (muscle pain and ache)
§ Arthralgia (aches and pains)
§ Low grade fever |
| Septic shock signs | Low Blood Pressure
Metabolic and cellular abnormalities
Cerebral effects
Sleepy; confused; agitated; aggressive –
Disseminated Intravascular Coagulation
Embolism |
| bacteria commonly systemic? | yes |
| Virus commonly systemic | no |
| yeast and fungi | uncommonly systemic |
| What to do in sepsis | SEPSIS = emergency situation requiring immediate care (phone 999; apply oxygen; legs elevated)
Regular antipyretic can be helpful
Anti‐infective treatment (see next |
