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block 10 anna > lecture 5 kidney and drugs > Flashcards

lecture 5 kidney and drugs Flashcards

1
Q

ADME

A

absorb
distribute
metabolism
excretion

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2
Q

steady state

A

equilibrium after so many doses

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3
Q

half life

A

time necessary to halve the plasma concentration

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4
Q

measure of the rate at which a substance is removed from the blood

A

clearance

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5
Q

diuretic

A

incr urine

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6
Q

chemical compound foreign to a given biological system

A

xenobiotics

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7
Q

what hormones can the kidney release

A

to control blood pressure

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8
Q

what controls the production of red blood cells

A

kidney

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9
Q

how can drugs be stopped from leaving via the kidney

A

protein bound

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10
Q

where is most things reabsorbed in the kidney

A

PCT

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11
Q

how does the charge of something affect clearance

QUERY

A

if something isnt charged its more likely to be reabsorbed into the blood so clearance is slower

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12
Q

how would fruit and veg affect your urine

A

alkaline urine

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13
Q

what might make urine acidic

A

protein

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14
Q

what kind of urine would clear an acidic drug fastest

A

alkalin urine

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15
Q

charged drugs tend to … the tubule

A

stay in

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16
Q

how does a drug being lipid soluble affect clearance

A

reabsorbed almost completely

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17
Q

what happens to clearance in renal failure

A

clearance rate is reduced

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18
Q

what can happen in aminoglycosides cause if they arent cleared in renal failure

A

otoxicity

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19
Q

what is otoxicity

A

infection of the ear

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20
Q

what is a diuretic

A

anything which promotes water loss

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21
Q

examples of food diuretics

A

celery, watermelon

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22
Q

carbonic anhydrase inhibitors target

A

H+/Na+ exchanged

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23
Q

example of carbonic anhydrase inhibitors

A

Acetazolamide

24
Q

how do the carbonic anhydrase inhibitors work

A

sodium isnt transported out of the tubule so it accumulates water in the filtrate

25
Q

what is the principle of osmotic diuresis

A

use something which drags water out with it

such as a sugar that cant be broken down

26
Q

example of an osmotic diuresis

A

D-mannitol

27
Q

where in the kidney do osmotic diuretics work

A

PCT

ascending loop of henle

28
Q

why might you use osmotic diuretics during neurosurgery

A

to reduce intracranial pressure

29
Q

why would you use osmotic diuretics in diabetic ketoacidosis or hypoglycaemic coma

A

patients dont respond to elevated glucose

and they have cerebral oedema

30
Q

what is IOP

A

intraocular pressure

31
Q

what might you use for elevated intraocular pressure

A

osmotic diuresis

32
Q

when should you not administor osmotic diuretics

A

if you dont know they have renal function

33
Q

what is the target of loop diuretics

A

inhibit the Na+/K+/2Cl- co-transporter

34
Q

which part of the enzyme do loop diuretics work on

A

Cl-

35
Q

how do loop diuretics work

A

stop sodium chloride getting out of the tubule

36
Q

examples of loop diuretics

A

furosemide

bumetanine

37
Q

when would you use loopdiuretics

A

left ventricular failure = pulmonary oedema

chronic cardiac failure

38
Q

what should be monitored when using loop diuretics

A

electrolytes

39
Q

what is the thiazide target

A

Na/Cl (K+) co-transporter

40
Q

where do thiazides work

A

DCT

41
Q

what do thiazides do

A

stop sodium reabsorption in the DCT

42
Q

how do you administer thiazides

A

orally

43
Q

how long do thiazides take to work

A

1-2 hours

44
Q

how do you administer loop diuretics

A

orally

45
Q

how long do loop diuretics take to work

A

1 hour

46
Q

how long for loop diuretics to complete diuresis

A

6 hours

47
Q

how long for thiazides to complete diuresis

A

12-24 days

48
Q

what time of day would you administer thiazides

A

early - so you dont disrupt sleep

49
Q

drug that works on the collecting tubule inhibiting sodium reabsorption

A

amiloride

50
Q

why is amiloride a mild diuretic drug

A

works on the collecting tubule and most of the sodium has already been reabsorbed

51
Q

why is spirolactone slow acting

A

effect on gene expression

52
Q

what is spiralctone

A

potassium spairing - less excreted

53
Q

what shouldnt you administer spirolactone with and why

A

ACE inhibitor - has an effect on potassium secretion

hyperkalkalaemia

54
Q

which two trugs might cause tubular toxicity

A

antibiotics such as aminoglycans and tetracyclines

55
Q

wnat might the chemo drugs cisplatin and methotroxate do to the kidneys

A

means you need intensive hydration

56
Q

what might NSAIDs do to the kidney

A

glomerulopathy

block 10 anna (9 decks)

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