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Drugs and Kidney: The Art and Responsibility

Drugs and Kidney: The Art and Responsibility. Hussein Sheashaa, MD, FACP Professor of Nephrology, Urology and Nephrology Center and Director of Medical E-Learning Unit, Mansoura University, and Executive Director of ESNT- Virtual Academy: http://lms.mans.edu.eg/esnt/.

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Drugs and Kidney: The Art and Responsibility

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  1. Drugs and Kidney:The Art and Responsibility Hussein Sheashaa, MD, FACP Professor of Nephrology, Urology and Nephrology Center and Director of Medical E-Learning Unit, Mansoura University, and Executive Director of ESNT- Virtual Academy: http://lms.mans.edu.eg/esnt/ Mansoura NGH; Feb 3rd, 2016

  2. Outline • Introduction • Use of renally inappropriate medication • Pharmaco (kinetics, dynamics, genomics) • Special drugs and situations • Closure

  3. Introduction

  4. Introduction: Drug Use JAMA. November 2015;314(17):1818-1831

  5. Introduction: Cost and cost Clin J Am Soc Nephrol 10: 1822–1830, October 2015.

  6. Use of Renally Inappropriate Medications

  7. Inappropriate Medications J Am Geriatr Soc 2015 in press

  8. Inappropriate Medications J Am Geriatr Soc 2015 in press

  9. Inappropriate Medications J Am Geriatr Soc 2015 in press

  10. Pharmacokinetics

  11. Pharmacokinetics:Bioavailability in CKD • Bioavailability: • Furosemidedosing oral/IV • Gancyclovir • Drug absorption • Iron • Iron and thyroxin

  12. Pharmacokinetics:Distribution in CKD • Distribution: • Free and total • Digoxin example

  13. Pharmacokinetics:Metabolism • Cytochrome system: • Enzyme inducers and inhibitors

  14. Pharmacogenetics:Metabolism and Transport

  15. Pharmacokinetics: Oral Antidiabetics Nephrol Dial Transplant (July 2014) 29: 1284–1300

  16. Pharmacodynamic

  17. Pharmacodynamics: Antidiabetics

  18. Pharmacodynamics: Antibiotics

  19. Pharmacodynamics: Perioperative Management ACEi /ARBS OCS

  20. Pharmacodynamics: Glomerular Disease Clin J Am Soc Nephrol 10: 1287–1290, July 7th, 2015.

  21. Pharmacogenomics

  22. Pharmacogenomics

  23. Preemptive Pharmacogenomics J Am Med Inform Assoc 2014;21:e93–e99.

  24. TPMT Nat Rev Drug Discov 2005; 4:639.

  25. Pharmacogenetics:Tacrolimus Scenario CLINICAL PHARMACOLOGY & THERAPEUTICS | VOLUME 98 NUMBER 1 | JULY 2015

  26. Tacrolimus Scenario: RCT, 240 Patients Erasmus MC, Rotterdam, The Netherlands American Journal of Transplantation, 2016; Accepted article

  27. Diabetes

  28. Glycemic Control Nephrol Dial Transplant (May 2015) 30: ii1–ii142

  29. Hypertension

  30. Hypertension: Drug Interactions J Am Soc Nephrol 26: 1248–1260, June 2015

  31. Hypertension: BB Dialysability Weir, et al. J Am Soc Nephrol 26: 987–996, 2015.

  32. Iron

  33. Pharmacodynamics: Iron Induced Anaphylaxis JAMA. 17 November 2015;314(19):2062-2068

  34. Iron Am J Kidney Dis. 2016, in press

  35. CRUISE Continuous Replacement Using Iron Soluble Equivalents: Phase 3, RCT, n 599, 48 w Nephrol Dial Transplant (December 2015) 30: 2019–2026

  36. PPI

  37. PPI and Myocardial Infarction

  38. PPI and CDI

  39. PPI and Hypomagnesemia Am J Kidney Dis. 2015;66(5):775-782

  40. PPI, Hypomagnesemia and AF International Journal of Cardiology (2016), in press

  41. PPI and Osteoporosis Bone 81 (2015) 675–682

  42. PPI and Pediatrics • SBBO • CDI, Salmonella, Campylob. • URTI • CAP, HAP, VAP • Celiac • Fundic gastric polyp • Rebound acidhypersecretion • Ca Malabsorption and BMD • VC, B12 • Mg • CVS • Interstitial Nephritis • Microbiome

  43. Hyperkalemia

  44. Hyperkalemia: New Treatment N Engl J Med 2015;372:222-31.

  45. CKD-MBD

  46. COMBINE Study The CKD Optimal Management With BInders and NicotinamidE study J Am Soc Nephrol 26: 2328–2339,October 2015

  47. Statins

  48. Statins Intolerance Expert Opin. Drug Saf. (June 2015) 14(6):935-955

  49. DKD: Use of Statins Nephrol Dial Transplant (May 2015) 30: ii1–ii142

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