Proton Pump Inhibitors and Acute Interstitial Nephritis

May 2006

CME ACTIVITIES

525

Proton Pump Inhibitors and Acute Interstitial Nephritis Geevasinga N, et al, Authors Test ID No.: 0010

Contact hours: 1.0

Expiration Date: May 31, 2007

Question 1: Which of the following is true about side effects related to proton pump inhibitors (PPIs):

a. Headache, dizziness, and diarrhea are the most common side effects b. Headache, dizziness, and diarrhea each occur in about 15% of treated patients c. Acute interstitial nephritis is more common with omeprazole than other PPIs d. Acute interstitial nephritis occurs more commonly with methicillin than with PPIs e. Acute interstitial nephritis is more common with pantoprazole than other PPIs

Question 2: Acute interstitial nephritis (AIN) from proton pump inhibitors has all the following features EXCEPT:

a. Nausea, vomiting, and malaise b. Asymptomatic c. Urine sediment reveals white cells, red cells, and white cell casts d. Proteinuria ⬎1 g per day e. Rash, fever, and eosinophilia

Question 3: Which of the following is true regarding acute interstitial nephritis (AIN) in patients on proton pump inhibitors?

a. b. c. d. e.

Renal Older Renal Renal Renal

toxicity is dose-related patients are at higher risk biopsy is usually normal impairment is mild dysfunction is usually irreversible

Question 4: Management of acute interstitial nephritis (AIN) caused by proton pump inhibitors: which of the following is NOT true:

a. Renal dysfunction within 2 weeks of starting PPIs is most likely related to PPI b. Renal function improves within 3–5 days in most patients on discontinuation of the drug c. Renal biopsies are to be considered if the serum creatinine continues to rise beyond 3 mg/dL after discontinuing the medication d. Prednisone might reverse AIN when given in a dose of 1 mg/kg e. Complete recovery of renal function takes place in most patients within 6 – 8 weeks