Is a Drug Interaction the Reason for This Patient's Acute Renal Failure?

Douglas S. Paauw, MD

Disclosures

March 16, 2015

New-Onset Renal Insufficiency

A 70-year-old man presents with persistent nausea and weakness. He has a history of coronary artery disease, hypertension, and depression. He was initially seen 1 week ago for nausea and abdominal pain and was started on treatment for ulcer disease associated with Helicobacter pylori. His current medications include low-dose aspirin, nifedipine, omeprazole, amoxicillin, fluoxetine, and clarithromycin.

His blood pressure at this time is 90/60 mm Hg, and his heart rate is 100 beats/min. You order a basic metabolic panel, which is notable for the following findings:

  • Blood urea nitrogen: 35 mg/dL;

  • Creatinine: 3.8 mg/dL; and

  • Potassium: 4.8 mEq/L.

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