Acute Interstitial Nephritis

00:01 An important topic is drug induced interstitial nephritis or also called acute interstitial nephritis or more commonly heard on the ward as AIN.

00:11 Now, this is when you have acute inflammation of the renal interstitium due to exposure to toxins or drugs.

00:19 Signs and symptoms include a fever, rash and you see an eosinophilia and 20 to 35% of patients, only about 10% of patients exhibit all three of these It should also be noted that there's no standard time frame for the onset of medication induced acute interstitial nephritis to take place.

00:37 So clinicians must be constantly on the lookout.

00:39 Now, how do you remember the causes of interstitial nephritis? Well, we used the mnemonic, P SQUARE.

00:46 The first is P and these include penicillin, the antibiotic; phenytoin, the antiepileptic; and proton pump inhibitors like pantoprazole.

00:56 Now, then you have S and here we have sulfa drugs such as Bactrim.

01:01 Q, quinolone and quinidine and U are drugs that make you urinate such as Lasix or hydrochlorothiazide.

01:01 Q, quinolone and quinidine and U are drugs that make you urinate such as Lasix or hydrochlorothiazide.

01:10 A for allopurinol and Advil, ibuprofen or NSAIDs here, and then R is for rifampin which recall will rev up cytochrome P450 and E is that this will cause an eosinophilic cast, a very high yield point to remember.

01:28 is that this will cause an eosinophilic cast, a very high yield point to remember.