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C&R TPX > C&R E4 > Flashcards

C&R E4 Flashcards

AKI Dialysis Drug Dosing CKD and Complications

1
Q

Midodrine, indication?

A

intradialytic hypotension

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2
Q

Midodrine, Dosing?

A

2.5mg - 10mg PO 30min prior to HD

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3
Q

Vitamin E, indication?

A

cramping from dialysis

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4
Q

Vitamin E, dosing?

A

400 IU PO

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5
Q

Quinine, what not indicated for?

A

Leg cramps, FDA warning for no leg cramps

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6
Q

Opioids that are okay to use in kidney dysfunction

A

Fentanyl
Methadone

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7
Q

Opioids that are okay to use CAUTIOUSLY

A

Hydromorphone
Oxycodone
Hydrocodone

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8
Q

Opioids CONTRA in kidney dysfunction

A

Morphine
Codeine
Meperidine

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9
Q

Antimicrobial NOT ADJUSTED FOR THE KIDNEY

A

Azithromycin
Ceftriaxone
Clindamycin
Doxycline
Linezolid
Metronidazole
Moxifloxacin

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10
Q

Anticoags NOT ADJUSTED FOR THE KIDNEY

A

Warfarin
Heparin
Argatroban

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11
Q

Benazepril, brand name

A

Lotensin

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12
Q

Captopril, brand name

A

Capoten

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13
Q

Enalapril, brand name

A

Vasotec

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14
Q

Fosinopril, brand name

A

Monopril

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15
Q

Lisinopril, brand name

A

Zestril or Prinivil

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16
Q

Moexipril, brand name

A

Univasc

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17
Q

Quinapril, brand name

A

Accupril

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18
Q

Ramipril, brand name

A

Altace

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19
Q

Trandolopril, brand name

A

Mavik

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20
Q

All ACEi are dosed QD… except…

A

Captopril (Capoten) – TID
Enalapril (Vasotec) – BID

Think shorter duration of action

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21
Q

Azilsartan, brand

A

Edarbi

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22
Q

Candesartan, brand

A

Atacand

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23
Q

Eprosartan, brand

A

Teveten

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24
Q

Irbesartan, brand

A

Avapro

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25
Q

All ARBs are dosed

A

QD

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26
Q

Losartan, brand

A

Coozar

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27
Q

Olmesartan, brand

A

Benicar

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28
Q

Telmisartan, brand

A

Micardis

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29
Q

Valsartan, brand

A

Diovan

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30
Q

RAASi DDI - AVOID, absolute contra

A

RAASi + NSAIDS –> AKI
RAASi + K+ Supp –> Hyperkalemia
RAASi + RAASi –> AKI and Hyperkalemia

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31
Q

Quinapril has —- and can not be used with —- and —-

A

Has Mg, can’t be used with fluroquinolones and tetracyclines

32
Q

RAASi DDI – Caution

A

K sparing diuretics/aldosterone antagonist –> Hyperkalemia
Li –> increase Li concentrations

33
Q

RAASi Contraindications for use - ABSOLUTE

A

Pregnancy
Bilateral renal artery stenosis
hx of ACE/ARB related angioedema

34
Q

RAASi Contraindications for use - Caution

A

Unilateral renal artery stenosis
Hyperkalemia
Dehydration/hypovolemia
Hypotension
Kidney Dysfunction (serum creatinine greater than 3)

35
Q

Tsat is …

A

functional iron

36
Q

Serum Ferritin is…

A

storage iron

37
Q

Hold IV iron for pt’s with …

A

Tsat > 50%
Serum Ferritin >1200 ml

38
Q

Iron Products (PO) DDI, impacting iron Absp, decrease iron absp

A

Tetracyclines, H2 antagonist, calcium carbonate, antacids, PPI, cholestyramine

39
Q

Iron Products (PO) DDI, drugs impacted by Iron

A

Fluroquinolone, levothyroxine, tetracycline, mycophenolate, methyldopa, levodopa

40
Q

Sevelamer carbonate, brand and why use?

A

Renvela, # 1 non ca binder (normal to high ca)

41
Q

Lanthanum carbonate, brand and why use?

A

Fosrenol, chewable non ca binder (normal to high ca)

42
Q

Ferric citrate, brand and why use?

A

Auryxia, iron deficiency anemia, non ca binder (normal to high ca)

43
Q

Sucroferric oxyhydroxide, brand and why use?

A

Velphoro, pill burden, normal to high non ca binder

44
Q

Calcium acetate, brand and why use?

A

PhosLo, #1 ca binder (low ca levels)

45
Q

calcium carbonate, brand and why use?

A

No brand name, cheaper ca binder (low ca levels) but higher risk of hypercalemia

46
Q

SGLT2i contra

A

Type 1 dm

47
Q

SGLT2i monitor

A

Gential mycotic infections
Fournier’s gangrene
Euglycemia DKA

48
Q

Sglt2 gfr must be….for initiation?

A

Greater than 20
Gfr 4 is greater than 15 to 30
Gfr 5 is less than 15

49
Q

Finerenone gfr must be ….for initation

A

Greater than 25 for initiation
Gfr 4 is greater than 15 to 30
Gfr 5 is less than 15

50
Q

Finerenone K must be…

A

Less than 5.5

51
Q

Anemia baseline goals
Hgb
Ferritin
Tsat

A

10-11
<500
>30%

52
Q

iron PO and drugs ddi OR Ca based phos binders and drugs ddi, seperate by….

A

2hrs

53
Q

Ferric gluconate brand

A

Ferrlecit

54
Q

Iron sucrose brand

A

Venofer

55
Q

Ferric gluconate dosing

A

125mg TIW x 8 doses

56
Q

Iron sucrose dosing

A

100mg 1 - 3 times a week
Total 1g

57
Q

Epoetin alpha brand

A

Epogen

58
Q

Darbepoetin alpha brand

A

Aranesp

59
Q

Methoxy polyethylene glycol epoetin beta brand

A

Mircera

60
Q

Shortest to longest duration of action epo

A

Epogen (TIW)
Aranesp (1 wk)
Mircera (2 wks)

61
Q

ESA Ade

A

Hypertension
Hypercoagulability with an increased risk of thrombosis (Thromboembolism and Stroke)
Malignancy
Pure red blood cell aplasia

62
Q

All phos binders DDI with…

A

Fluoroquinolones
Levothyroxine
Iron (The iron-based ones don’t ddi with iron obvi)

63
Q

Non Ca based phos binder ADE and DDI

Think drug class

A

Sevelamer: GI upset and diarrhea
Lanthanum: GI upset

other rx need to be 1hr prior or 3 hrs after (since phos binding will have DDI)

64
Q

Iron based phos binder ADE

A

Ferric Citrate ADE: GI, diarrhea, iron overload, stool discolouration
Sucroferic (Velphro): GI, diarrhea

65
Q

Vitamin D Analogs in tpx flowchart

A

Doxercalciferol
Pericalcitol

66
Q

What is active vitamin D

A

1,25 - OH D3 (Calcitriol)

67
Q

Vitamin D2

A

Ergocalciferol

68
Q

Vitamin D3

A

Cholecalciferol

69
Q

Calcifediol indication

A

Approved for MBD in CKD 3 and 4, not ESRD

70
Q

Cinacalcet brand

A

Sensipar

71
Q

Cinacalcet (Sensipar) indication

A

calcimimetic therapy

72
Q

Cinacalcet (Sensipar) dosing

A

30mg/day PO and titrate up every 2 - 4 weeks to MDD 180mg

73
Q

Cinacalcet (Sensipar) Pearls

A

treat Ca if < 8.4

74
Q

Cinacalcet (Sensipar) ADE

A

N/V
Hypocalcemia – need to monitor within 1 wk and then monthly
QTc prolongation and ventricular arrhythmias

75
Q

Etelcalcetide brand name?

A

Parsabiv

76
Q

Etecalcetide indication?

A

2nd line calcimimetic THAT IS GIVEN IV AT HD

77
Q

Which iron therapy needs a 25mg testing dose?

A

Iron dextran

C&R TPX (4 decks)

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