Abstract
Introduction:Darifenacin is a medication that has anticholinergic and antimuscarinic effects and is used in the treatment of overactive bladder.Adverse and overdose effects of the medication such as dry mouth and eyes,headache,nausea, constipation, urinary retention, and dyspepsia have been reported .An overdose effect on AKI has not been reported in the literature, and no dose adjustment is recommended in patients with renal impairment
Case:A 24-year-old male patient applied to the emergency department with a declaration of taking 25 drugs containing darifenacin active ingredient for suicidal purposes.The patient had complaints of nausea and difficulty urinating.The patient's physical examination was normal.In laboratory, creatinine was 2.09mg/dL, and hemoglobi (+++) and protein(++) were found in urine test.Renal USG revealed a grade 1-2 increase in echogenicity of both kidneys.The patient was followed up with intravenous fluid replacement therapy, and the patient whose creatinine levels regressed was discharged with the recommendation of nephrology outpatient control.
Conclusion:Any molecule taken in overdose can cause AKI via ATN should not be ignored by emergency physicians.The fact that such a side effect or undesirable situation has not been reported with Darifenacin so far doesn’t mean that the molecule is safe for this situation.An overdose of Darifenacin may cause AKI in patients.
Keywords
Acute kidney injury darifenacine drug overdose emergency medicine kidney tubular necrosis suicide (MeSH Database).
References
- 1. Khwaja A. KDIGO clinical practice guidelines for acute kidney injury.Nephron Clin Pract 2012;120(4):c179-84.
- 2. EMSELEX 15 MG 28 UZATILMIŞ SALIM TABLET. Available: February 14, 2021, https://www.ilacabak.com/emselex-15-mg-28-uzatilmis-salim-tablet-6266/kisa-urun-bilgisi.
- 3. Uchino S, Bellomo R, Goldsmith D, Bates S, Ronco C.An assessment of the RIFLE criteria for acute renal failure in hospitalized patients.Crit Care Med 2006;34(7):1913-7.
- 4. Liaño F, Pascual J.Epidemiology of acuterenalfailure: a prospective, multicenter, community-basedstudy. Madrid Acute Renal Failure Study Group.KidneyInt 1996;50(3):811-8.
- 5. Rosner MH, Okusa MD. Drug-associated acute renal failure in the intensive care unit. In: Clinical Nephrotoxins – Renal Injury from Drugs and Chemicals, 3rd ed., De Broe ME, Porter GA, Bennett WM, Deray G (Eds), Kluwer Academic Press, Boston 2008.
- 6. Sales GTM, Foresto RD. Drug-induced nephrotoxicity. Rev Assoc Med Bras 2020;66(1):82-90.
- 7. Ansari FA, Manuel S, Dwivedi R, Boraiah SK, et al. A Rare Case of Acute Kidney Injury Due to Levofloxacin-induced Crystal Nephropathy.Indian J Nephrol 2019;29(6):424-426.
Abstract
Giriş: Darifenasin, antikolinerjik ve antimuskarinik etkileri olan ve aşırı aktif mesane tedavisinde kullanılan bir ilaçtır.İlacın ağız ve göz kuruluğu, baş ağrısı, bulantı, kabızlık, idrar retansiyonu ve dispepsi gibi yan ve doz aşımı etkileri bildirilmiştir.AKI ile ilgili bir doz aşımı etkisi literatürde bildirilmemiştir ve böbrek yetmezliği olan hastalarda herhangi bir doz ayarlaması önerilmemektedir.
Olgu: 24 yaşında erkek hasta, suicid amaçlı 25 adet darifenasin etken madde içeren ilaçtan alma beyanı ile acil servise başvurdu.Hastanın bulantı ve idrar yapmada zorlanma şikayetleri mevcuttu.Fizik muayenesinde normal olan hastanın, laboratuvarında kreatinin: 2.09 mg/dL, tam idrar tetkikinde hemoglobin (+++) ve protein (++) saptandı.Renal USG’sinde her iki böbrek ekojenitesinin grade 1-2 arttığı raporlandı.Hasta intravenöz sıvı replasman tedavisi ile takip edildi, kreatinin değerleri gerileyen hasta nefroloji poliklinik kontrol önerisi ile taburcu edildi.
Tartışma: Aşırı dozda alınan herhangi bir molekülün ATN yoluyla AKI’ya sebep olabileceği acil hekimleri tarafından göz ardı edilmemelidir.Şu ana kadar Darifenasin ile ilgili böyle bir yan etkinin veya istenmeyen durumun rapor edilmemiş olması, bu durum açısından ilgili molekülün güvenli olduğu anlamına gelmez.Aşırı dozda alınan Darifenasin hastalarda AKI’ya sebep olabilir.
Keywords
Akut böbrek hasarı darifenasin ilaç aşırı dozu acil tıp böbrek tübüler nekrozu intihar (MeSH Database).
References
- 1. Khwaja A. KDIGO clinical practice guidelines for acute kidney injury.Nephron Clin Pract 2012;120(4):c179-84.
- 2. EMSELEX 15 MG 28 UZATILMIŞ SALIM TABLET. Available: February 14, 2021, https://www.ilacabak.com/emselex-15-mg-28-uzatilmis-salim-tablet-6266/kisa-urun-bilgisi.
- 3. Uchino S, Bellomo R, Goldsmith D, Bates S, Ronco C.An assessment of the RIFLE criteria for acute renal failure in hospitalized patients.Crit Care Med 2006;34(7):1913-7.
- 4. Liaño F, Pascual J.Epidemiology of acuterenalfailure: a prospective, multicenter, community-basedstudy. Madrid Acute Renal Failure Study Group.KidneyInt 1996;50(3):811-8.
- 5. Rosner MH, Okusa MD. Drug-associated acute renal failure in the intensive care unit. In: Clinical Nephrotoxins – Renal Injury from Drugs and Chemicals, 3rd ed., De Broe ME, Porter GA, Bennett WM, Deray G (Eds), Kluwer Academic Press, Boston 2008.
- 6. Sales GTM, Foresto RD. Drug-induced nephrotoxicity. Rev Assoc Med Bras 2020;66(1):82-90.
- 7. Ansari FA, Manuel S, Dwivedi R, Boraiah SK, et al. A Rare Case of Acute Kidney Injury Due to Levofloxacin-induced Crystal Nephropathy.Indian J Nephrol 2019;29(6):424-426.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Case Report |
| Authors | |
| Early Pub Date | June 22, 2022 |
| Publication Date | June 23, 2022 |
| Submission Date | December 8, 2021 |
| Published in Issue | Year 2022 Volume: 13 Issue: 2 |
