The kidneys are remarkably susceptible to damage by drugs.1,2 Some of these agents, eg, aminoglycoside antibiotics, are well-known nephrotoxins and are used with appropriate caution. The nephrotoxic potential of many other widely used drugs, including newer agents, eg, the nonsteroidal anti-inflammatory drugs, as well as such older agents as furosemide, allopurinol, iodinated contrast media, cephalosporins, penicillins, sulfonamides, and tetracyclines, is less well recognized. This article is a brief review of the agents in these groups of drugs that appear to be of the greatest clinical importance.
PROSTAGLANDIN INHIBITORS
These compounds include the nonsteroidal antiinflammatory drugs, widely used in the treatment of a number of rheumatologic disorders. Aspirin and phenacetin also fall into this category. Most prostaglandins are renal vasodilators, and, consequently, agents that inhibit prostaglandin synthesis, eg, indomethacin, phenylbutazone, ibuprofen, fenoprofen calcium, naproxen, sulindac, tolmetin sodium, and zomepirac sodium, as well as aspirin and phenacetin, may decrease renal blood