Urology mod 3 Flashcards
drug for CKD - hyperphosphatemia
calcium carbonate (Tums)
MOA: Binds to phosphate
Goals of therapy:
Keep phosphate levels normal (or near normal)
Reduce mortality
Important for patient to take with meals
Adverse effect:
Hypercalcemia (monitor calcium levels)
Calcitriol (1, 25-dihydroxyvitamin D)
renal osteodystrophy
MOA:
Activated form of Vitamin D
Stimulates intestinal absorption of calcium/phosphate and bone mineralization
Adverse effects:
Hypercalcemia- GI upset, bone pain, neuro effects, cardiac arrhythmias
Hyperphosphatemia
UTI - ABX
ciprofloxacin and vancomycin
bladder cancer
BCG vaccine
MOA: Stimulates a local inflammatory response
Adverse effects:
Bladder irritation!
Risk of systemic infection
Patient instructions:
Empty bladder
Dwell time = __2_ hours
Change positions q _15__ minutes
takes 6-12 weeks
acute kidney infections drugs
Goal of treatment is to stabilize patient until kidney function is returned
Management includes
Correct fluid, electrolyte imbalance (particularly hyperkalemia)
- Lasix to try to push kidneys to function and remove potassium
- Dextrose and insulin to help move K back into cells
Binders
- sodium polystyrene sulfonate (Kayexalate)
- patiromer(Veltassa)
- sodium zirconium cyclosilicate (Lokelma)
Correct Acid-base imbalance (metabolic acidosis)
- Sodium bicarbonate
Manage blood pressure
Avoid drugs that are nephrotoxic
treat the underlying causes of CKD
Slow the rate of progression of CKD
Reduce BP to less than 140/90
Treat hyperlipidemia (cholesterol less than 200)
Treat the complications of CKD Volume overload Hyperkalemia Metabolic acidosis Hyperphosphatemia Renal osteodystrophy Anemia
slow the progression of CKD
Blood pressure control ACE or ARB Other BP meds as needed to maintain SBP (110-130) 140 Lipid control Statins as needed
glomerular disorders
Corticosteroids such as prednisone
Diuretics
Immunosuppressants
Anti-hypertensives – ACE or ARB
Other Treatment
Dialysis
Diet
nephrolithiasis - kidney stones
Acute Pain: Morphine or NSAIDS IV fluids Preventive meds: Calcium = thiazide diuretics Struvite = antibiotics Urate = allopurinol (covered in gout lecture)
