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Medications
Common medications used in kidney failure
are listed below. For a complete description of the medications, click http://www.nlm.nih.gov/medlineplus/druginformation.html
Indications and goals of treatment are recommended by the National
Kidney Foundation which can be accessed at the K/DOQI
site.
Anemia
- Erythropoietin (Procrit, Epogen, Aranesp) is used
as subcutaneous injection every 1-4 weeks to correct the anemia.
- Iron (Ferrous Sulfate, Ferrous Fumarate, Venofer injection,
Ferrilicit injection) is used to replete iron stores in the body to help
erythropoietin produce red blood cells and correct the anemia.
Bone disease - Phosphorous binders
(Oscal,Tums, Phoslo) are older medications used as phosphate binders.
They are taken with food for proper action. Newer medications (Renagel,
Fosrenol) are also phosphate binders which your doctor can consider
prescribing on individual situation.
- Parathyroid suppresion (Rocaltrol, Hectrol, Calcijex, Sensipar)
are prescribed to suppress the over-active parathyroid glands. These are
given orally or intravenously during your dialysis.
Diabetes
- Oral medications All oral medications except
Glucophage are acceptable in kidney failure. Doses
required may be less which can be adjusted with the help of your
physician.
- Insulin (Lantus, Regular, 70/30, Lente) can be
prescribed by your physician in kidney failure. Lower doses may be
required in kidney failure which can be adusted with the help of your
physician.
Hyperkalemia
- Kayexalate is commonly prescribed to lower the potassium
rapidly in your blood. High potassium is potentially dangerous (cardiac
arrest) and has to be treated rapidly. Following a low potassium
diet if prescribed by your physician is essential in maintaining the
potassium in reasonable range.
Hypertension -
ACE inhibitors Lisinopril, Enalapril etc. are the mainstay for
treating chronic kidney disease. In addition to controlling the
blood pressure, they have the additional benefit of preserving the
kidney function. Like all other medications, they work better in
some patients and less well in others. Combining an ARB with ACE
inhibitor may provide additional benefit in some patients. Side effects
such as dry cough and hyperkalemia are common. Hyperkalemia should be
watched for and some patients should follow a strict low potassium diet.
- ARBs Cozaar, Benicar etc. lower blood pressure and preserve
kidney function. Some patients respond better than others.
They are sometimes combined with ACE inhibitors. Hyperkalemia
should be watched for and some patients should follow a strict low
potassium diet.
-
Beta-blockers Atenolol, Metoprolol, Propranolol lower
blood pressure. Since kidney patients are at risk of heart disease,
these medications are considered by your physician.
- Calcium channel blockers Verapamil, Diltiazem are used
to control the blood pressure. They may help reduce the
proteinuria in some patients.
- Centrally acting agents Clonidine, Guanfacine are
blood pressure controlling agents.
- Diuretics Furosemide (Lasix), Demadex, Bumex are
used to control the fluid retention. Hydrochlorthiazide (HCTZ) is
sometimes used with other medications to lower the blood pressure.
- Alpha-blockers Cardura etc. are used to control teh
blood pressure. They may also help some men with prostate
enlargement.
Antibiotics - Many
antibiotics need adjustment in kidney failure. Discuss this with
your doctor or pharmacist.
Nutrition
- Patients with poor nutrition are
sometimes prescribed Megace to stimulate the appetite in addition to
nutrition supplements.
Pain
Meds - Patients are advised to
avoid Darvocet if their kidney function is low. Other medications
may need adjustment in dosage.
References
http://www.nlm.nih.gov/medlineplus/druginformation.html
List
of drugs in the U.S with description of indications, dose and side
effects.
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