Nephrology 2 Flashcards
How long after aminoglycoside administration is started does nephrotoxicity occur?
5-10 days
What other toxicity do aminoglycosides tend to cause?
ototoxicity
Is toxicity from aminoglycosides related to the peak or trough drug concentration?
trough
How do administer aminoglycosides to a pt w/ renal dysfunction?
space the dosing interval
How does renal insufficiency cause susceptibility to infection?
uremia inhibits leukocyte degranulation
How does renal insufficiency cause bleeding?
uremia causes platelet dysfunction
What cardiac problem does uremia cause?
pericarditis
What do you give in case of bleeding d/t uremia?
DDAVP (desmopressin)
How does DDAVP cause temporary plt activation?
release of subendothelial vWF and factor VIII
How fast does creatinine rise if the kidneys are completely nonfunctional?
0.5 - 1 mg/dL per day
What syndrome causes orthodeoxia?
hepatopulmonary syndrome
What drugs can cause retroperitoneal fibrosis and therefore bilateral ureteral disease?
Bleomycin and methotrexate
What diseases are the 2 most common causes of neurogenic bladder in the U.S.?
DM and MS
What is first priority in case of rhabdomyolysis?
protect the heart from hyperKALEMIA
The amount of contact time btwn myoglobin and the renal tubules determines the amount of damage. What nephroprotective measures must be taken in case of rhabdomyolysis?
hydration, mannitol, and bicarbonate (prevents precipitation of myoglobin)
