Clinical Pharmacology Flashcards Preview

Urinary Systems > Clinical Pharmacology > Flashcards

Flashcards in Clinical Pharmacology Deck (20):
1

How does renal disease affect clinical pharmacology?

If renal function is impaired then there will be a rapid build up of either ACTIVE DRUG or possibly TOXIC OR ACTIVE METABOLITES

2

What drugs will renal disease not effect so much?

If the drug used or its metabolites have a high therapeutic index or low toxicity then no problem
-benzylpenicillin

3

What drugs are particularly at risk of large effects by renal disease?

If the drug or its metabolites have a narrow therapeutic index then toxicity or death

-Gentamicin
-Digoxin
-Lithium
-Tacrolimus

4

What are the side effects of gentamicin?

May cause renal or ototoxicity

5

What are the side effects of digoxin?

May cause arrhythmia, nausea or death

6

What are the side effects of lithium?

Renal toxicity and death

7

What are the side effects of tacrolimus?

Renal and CNS toxicity

8

What must doctors do in response to reduction in GFR?

PHARMACOKINETIC EFFECTS ->

-REDUCE DOSAGE
-Increase dose interval
-Therapeutic Drug Monitoring of gentamicin, lithium, digoxin, vancomycin etc

9

Drug induced renal toxicity can cause 4 major syndromes.

What are they?

Acute renal failure

Nephrotic syndrome

Renal tubular dysfunction with potassium wasting

Chronic renal failure

10

What is acute renal failure?

A sudden deterioration in renal function which results in a rapid rise in creatinine.

Urine volume falls to

11

What drugs can cause acute tubular necrosis?

Aminoglycoside antibiotics

Amphotericin B

Cisplatin (causes renal failure in up tp 25% of patients after a single dose), radiocontrast agents

Statin drugs given in combination with immunosuppressive agents such as cyclosporin

12

In what ways do drugs frequently induce renal disease?

Assymptomatic increase in urea and creatinine

Fluid and electrolyte abnormalities

Acute tubular necrosis

Acute and chronic interstitial nephritis

13

What is the most common drug induced renal disease?

Acute renal failure due to Acute Tubular Necrosis
-Caused by aminoglycosides

14

Who should you avoid nephrotoxic drugs in?

Volume deplete or hypotensive patients with pre-existing renal disease

Avoid nephrotoxic drugs in patients recieving other nephrotoxic agents

15

What drugs can cause acute tubular necrosis?

Gentimicin
Cephalosporins
NSAIDs

16

What drugs can cause acute interstitial nephritis?

Penicillin
NSAIDs

17

What drugs can cause post renal haemorrhage?

Anticoagulants

18

What drugs can cause retroperitoneal fibrosis?

Methysergide

19

What drugs can cause volume depletion or renal artery occlusion?

Frusemide
Amphotericin B

20

What drugs may cause acute tubular necrosis?

AMINOGLYCOSIDE antibiotics

NSAIDs