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Nephrotoxic drugs should, if possible, be avoided in patients with renal disease because the consequences of nephrotoxicity are likely to be more serious when renal reserve is already reduced. Dose recommendations are based on the severity of renal impairment. Prescribing in renal impairment liver disease is associated with reduced protein binding and increased toxicity of some highly protein-bound drugs such as phenytoin and prednisolone. prothrombin time, increases the sensitivity to oral anticoagulants such as warfarin and phenindione.
Any suspicion of such an association should be reported directly to the MHRA through the Yellow Card Scheme. The elderly Particular vigilance is required to identify adverse reactions in the elderly. Aspirin tablets allowed to dissolve in the sulcus for the treatment of toothache can lead to a white patch followed by ulceration. Flavouring agents, particularly essential oils, may sensitise the skin, but mucosal swelling is not usually prominent. g. methotrexate. Other drugs capable of causing oral ulceration include captopril (and other ACE inhibitors), gold, nicorandil, NSAIDs, pancreatin, penicillamine, proguanil, and protease inhibitors.
Clonidine, methyldopa) and with vinca alkaloids. Swelling of the salivary glands can occur with iodides, antithyroid drugs, phenothiazines, ritodrine, and sulfonamides. Taste There can be decreased taste acuity or alteration in taste sensation. Drugs implicated include amiodarone, calcitonin, captopril (and other ACE inhibitors), carbimazole, clarithromycin, gold, griseofulvin, lithium salts, metformin, metronidazole, penicillamine, phenindione, propafenone, protease inhibitors, terbinafine, and zopiclone.
British National Formulary 61 by Bma