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   What is a triple whammy?

   • line at:www.bpac.org.nz/2018/triple-whammy.aspxUnderstanding the “triple whammy”The term “triple whammy” refers to the concurrent use of an angiotensin converting enzyme (ACE) inhibitor or an angiotensin-II receptor blocker (ARB), with a diuretic and a non-st

   Avoiding the “triple whammy” in primary care: ACE inhibitor/ARB

   bpac.org.nz/2018/docs/triple-whammy.pdf

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   What is triple whammy Aki?

   • AKI resulting from combined therapy with NSAIDs, ARAs/ACEIs and diuretics is referred to as “triple whammy” ( Thomas, 2000, Loboz and Shenfield, 2005, Lapi et al., 2013, Onuigbo, 2013 ). This article analyses the combined mechanisms of action and determinants leading to pre-renal, triple whammy AKI. 2.

   Mechanisms of triple whammy acute kidney injury - ScienceDirect

   www.sciencedirect.com/science/article/pii/S016372581630136X

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   Is a triple whammy associated with pre-renal Aki?

   • The triple whammy was the only model associated with pre-renal AKI accompanied by a course of other risk factors, among numerous potential combinations of clinical circumstances causing hypoperfusion in which renal autoregulation is not operative or is deregulated.

   Mechanisms of triple whammy acute kidney injury - PubMed

   pubmed.ncbi.nlm.nih.gov/27490717/

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   What is acute kidney injury & triple whammy syndrome?

   • 1. Acute kidney injury and the triple whammy syndrome The term acute kidney injury (AKI) encompasses a number of aetiopathologically heterogeneous conditions leading to an abrupt decline in renal excretory function causing azotaemia, alterations in urinary flow (typically oliguria), or both.

   Mechanisms of triple whammy acute kidney injury - ScienceDirect

   www.sciencedirect.com/science/article/pii/S016372581630136X

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   How does a triple whammy affect BP control?

   • In contrast, single and double whammies either maintain BP control or affect renal autoregulation capacity to maintain GFR. In the triple whammy scenario, both BP control and autoregulatory capacity are severely handicapped.

   Mechanisms of triple whammy acute kidney injury - ScienceDirect

   www.sciencedirect.com/science/article/pii/S016372581630136X

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   Does triple whammy treatment increase the risk of acute kiloma (Aki)?

   • Clinical studies report higher odds of AKI for patients subjected to triple whammy treatments, than for those subjected to double or single whammies ( Thomas, 2000, Loboz and Shenfield, 2005, Lapi et al., 2013, Fournier et al., 2014, García Camin et al., 2015 ).

   Mechanisms of triple whammy acute kidney injury - ScienceDirect

   www.sciencedirect.com/science/article/pii/S016372581630136X

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2. bpac.org.nz › 2018 › triple-whammyAvoiding the triple whammy in primary care: an ACE inhibitor ...

   bpac.org.nz › 2018 › triple-whammy

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   The term “triple whammy” refers to the concurrent use of an angiotensin converting enzyme (ACE) inhibitor or an angiotensin-II receptor blocker (ARB), with a diuretic and a non-steroidal anti-inflammatory drug (NSAID), including cyclo-oxygenase-2 (COX-2) inhibitors.

3. bpac.org.nz › 2018 › docsAvoiding the “triple whammy” in primary care: ACE inhibitor ...

   bpac.org.nz › 2018 › docs

   Understanding the “triple whammy” roidal anti-inflammatory drug (NSAID), including cyclo-oxygenase-2 (COX-2) inhibitors. ACE inhibitors or ARBs and diuretics are commonly prescribed together, either as individual medicines or combination formulations, however, prescribers should remember that.

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5. pmc.ncbi.nlm.nih.gov › articles › PMC1884747Drug combinations and impaired renal function – the ‘triple ...

   pmc.ncbi.nlm.nih.gov › articles › PMC1884747

   Recent studies have identified the ‘triple whammy’ in which combinations of diuretics, nonsteroidal anti-inflammatory drugs (NSAIDs), ACE inhibitors (ACEI) and/or angiotensin receptor antagonists (ARA) may impair renal function.

6. cks.nice.org.uk › topics › nsaids-prescribing-issuesNSAIDs - prescribing issues: Scenario: NSAIDs - CKS | NICE

   cks.nice.org.uk › topics › nsaids-prescribing-issues

   Note: combined treatment with an NSAID, plus an ACE inhibitor or AIIRA and a diuretic (the so-called 'triple whammy') significantly increases the risk of acute kidney injury (AKI) and should be avoided if possible.

7. Videos

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     Triple Whammy: What Is It And How It Impacts Kidney Function | ft. Emily Cahill

     10 Jun 2021

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     Triple Whammy: What Does It Mean & How It Can Affect Your Kidney Health | #TripleWhammy #Drug

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     Whole Brain Teaching: Kindergarten Triple Whammy Sentences!

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8. www.bmj.com › content › 346The nephrotoxic “triple whammy” of combining diuretics, ACE ...

   www.bmj.com › content › 346

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   Feb 19, 2013 · In our 2008 report on 100 patients with chronic kidney disease and worsening AKI while receiving angiotensin inhibiting agents, there was a clear association with the concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs) in 10 patients.4 As early as 2000, an Australian report described the potential nephrotoxic harm from combining ...

   • Author: Macaulay A Onuigbo

   • Publish Year: 2013

9. pubmed.ncbi.nlm.nih.gov › 27490717Mechanisms of triple whammy acute kidney injury - PubMed

   pubmed.ncbi.nlm.nih.gov › 27490717

   The triple whammy was the only model associated with pre-renal AKI accompanied by a course of other risk factors, among numerous potential combinations of clinical circumstances causing hypoperfusion in which renal autoregulation is not operative or is deregulated.

10. www.sciencedirect.com › science › articleMechanisms of triple whammy acute kidney injury - ScienceDirect

    www.sciencedirect.com › science › article

    Nov 1, 2016 · The triple whammy was the only model associated with pre-renal AKI accompanied by a course of other risk factors, among numerous potential combinations of clinical circumstances causing hypoperfusion in which renal autoregulation is not operative or is deregulated.