Drugs - Renal Flashcards Preview

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Flashcards in Drugs - Renal Deck (50):
1

Uses of ACEI

HTN, Heart Failure, CKD, Diabetic nephorpathy

2

Side Effects of ACEI

Cough, Hyperkalemia, Increased Serum Creatinine, Angioedema
Contraindicated in pregnancy

3

Side Effects of ARBs

Same as ACEI: increased K, Cr, angioedema. No Cough

4

Lisinopril

ACEI

5

Amlodipine

CCB - DHP

6

Nifedipine

CCB - DHP

7

Diltiazem

CCB - NDHP

8

Verapamil

CCB - NDHP

9

DHP vs NDHP CCB

DHP are selective to peripheral calcium channel blockers and do not effect cardiac. (more potent vasodilation)
NDHP are non-selective and effect CO (decrease) - less potent vasodilators than DHP

10

DDI for DHP

Potent inhibition and metabolism by CYP450
Statins, amiodarone, cyclosporin, carbamazepine, grapefruit, macrolides

11

DDI for NDHP

mild inhibition of CYP450

12

Uses of CCB

DHP: HTN (second line for African American and Elderly), migraine prevention
NDHP: HTN, Agina, A fib, migraine prevention

13

Side Effects of CCB

DHP: Peripheral Edema, tachycardia, gingival hyperplasia
NDHP: Nausea, constipation, negative inotrope

14

Uses of Beta Blockers

HTN, PostMI, HF, Migraines

15

Side Effects of Beta Blockers

Sexual Dysfunction, bradycardia, bronchospasm, glucose and lipid dysregulation

16

Selective B-blockers

Atenolol and Metoprolol

17

Atenolol elimination

Renal

18

Metoprolol elimination

Liver

19

Propanolol

Nonselective Beta Blocker

20

Nonselective beta Blockeras

Propanolol and Timolol

21

Beta and Alpha Blockers

Carvedilol and Labetalol - good anti HTN

22

Hydralazine

Vasodilator to increase cGMP and release NO.

23

Minoxipil

Vasodilator to increase cGMP

24

Side Effect of Vasodilators

Tachycardia, lupus Like, Hair growth, edema, neuropathy

25

Alpha -1 blockers

Prozasin, terazosin, doxazosin - decrease NE release and decrease SVR

26

Uses of Alpha-1 blockers

3/4 line HTN, BPH

27

Adverse effects of Alpha-1 blockers

orthostatic hypotension

28

Clonidine

centrally acting Alpha2 AR agonists. To decrease PVR and HR. (decreases presynaptic Calcium)

29

Adverse effects of clonidine

Ortho hypo, dry mouth, sedation

30

Uses of Clonidine

3/4 HTN, ADHD, smoking cessation

31

Methyldopa

Alpha2 AR agonist used to treat HTN in pregnancy. But rarely used due to hepatotoxicity, sedative, adverse side effects

32

Sodium Nitroprusside

NO donor to activate ganyl Cyclase to cause smooth muscle relaxation.
Immediate onset.

33

Uses of Mannitol

Intracranial Pressure, Glaucoma

34

Acetazolamide

Used for Glaucoma, metabolic alkalosis, AMS
Side Effects: Metabolic acidosis

35

Bumetanide

Loop diuretic

36

Side Effects of Loop Diuretics

Gout, hypokalemia, hypocalcemia, hypomagnesium, metabolic alkalosis, ototoxicity

37

Side Effects of Thiazide Diuretics

Decreased K and Mg, increase Uric acid and calcium. Hyperglycemia and lipids.

38

Three agents after Transplant

1) Clacinerin Inhibitor
2) Proliferation Inhibitor
3) Prednisone

39

Calcinerin Inhibitor Examples

Cyclosporin and Tacrolimus

40

Mechanisms of Calcinerin Inhibitors

Inhibit dephosphorylation of NFAT to decrease IL-2

41

MMF

proliferation inhibitor to decrease Purine synthesis

42

mTOR inhibitors

Sirolimus - proliferation inhibitor to bind to FKBP

43

CKD - Distribution of drugs

Increased or decreased Volume of distribution leads to toxicity

44

What medicine must you dose for diabetes

Glyburide and Insulin

45

HTN - what medicine must you dose?

Diuretics - thiazides loose effectivity due to decreased delivery. Use loop
ACEI/ARB: use throughout
BB: only atenolol needs adjustment
No adjustments for CCB, alpha blockers, vasodilators, clonidine

46

Treatment of Anemia in CKD

Epoetin and Darbepoetin
Recombinant DNA Erythropoetin analogs

47

Calcium Acetate

used to tx osteodystrophy. a phosphate binding agent that binds to phosphate in GI to form insoluble form so it is fecally excreted.

48

Calcimimetics

binds to calcium sensors on parathyroid gland to decreases parathyroid hormone secretion. Potent inhibitors of CYP2D6

49

What drugs cause hyperkalemia

AA, ACEI, ARB, Digoxin

50

Tx of chronic hyperkalemia

Sodium Polystyrene sulfonate to bind to K in intestine to decrease K absorption.