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Renal > Glasgow Pharm > Flashcards

Glasgow Pharm Flashcards

(56 cards)

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1
Q

PGE2/PGI2 Renal

A

Increase renal blood flow
Decrease ADH induced water reabsorption
Decrease Chloride Reabsorption in Loop of Henle
Increase Renin Release

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2
Q

Adrenocorticosteroids that do not activate MR receptor

A

Triamcinolone
Betamethasone
Dexamethasone

Due to substitution on D ring.

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3
Q

Enzyme that takes Cortisol to Cortisone

A

11-Beta-Hydroxysteroid dehydrogenase 2

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4
Q

Synthetic Aldosterone like drug

A

Fludrocortisone

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5
Q

MR Receptor Antagonists

A

Spironolactone
eplerenone

Used for aldosterone excess, or cortisol excess.

S/E: hyperkalemia, metabolic acidosis, gynecomastia (esp Spiron), impotence (esp Spiron), and GI.

Spironolactone is a bit of an androgen receptor antagonist.

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6
Q

Fully activated form of Vitamin D

A

Calcitriol (1, 25-dihydroxy-cholecalciferol)

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7
Q

DHT—dihydrotachysterol

A

Vitamin D Synthetic derivative

no 1-OH needed for activation; does need liver 25-OH

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8
Q

1-alpha-hydroxycholecalciferol

Doxercalciferol (1-hydroxyvitamin D2)

A

already has 1-OH group

Does need liver 25-OH

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9
Q

Paricalcitol

A

Calcitriol Analog

reduces PTH without hypercalcemia
used in chronic renal failure

Analogs used when trying to shut down PTH after get calcium levels where they need to be.

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10
Q

22-oxacalcitriol

A

Calcitriol Analog

Suppressor of PTH gene expression, limited action on intestine and bone. Used in chronic renal failure, primary hyperparathyroidism. Low affinity for serum binding protein leads to shorter half life than calcitriol.

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11
Q

Sevelamer

A

Phosphate binding polymer

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12
Q

Cinacalcet

A

“calcimimetic.” Inhibits PTH secretion by enhancing the sensitivity of the CaSR (calcium receptor in the parathyroid gland). Lowers the concentration of Ca at which PTH secretion is suppressed.

Approved for treatment of secondary hyperparathyroidism due to chronic renal failure.

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13
Q

colchicine

A

Gout Drug used in Acute Attack when NSAIDs don’t work

interferes with mitotic spindle function
inhibits migration and phagocytic actions of granulocytes
inhibits neutrophil elaboration of inflammatory glycoprotein

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14
Q

NSAIDs used in Acute Gout Attack

A

naproxen, indomethacin, sulindac

These are your stronger NSAIDs

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15
Q

allopurinol

A

Used in chronic gout

parent drug and metabolite alloxanthine inhibit
xanthine oxidase, decrease uric acid synthesis

drug interaction: inhibits metabolism of azathioprine, 6-mercaptopurine

can be used with impaired renal function

Since it is a purine, it can interferer with metabolism of other purines like azothiaprine and 6-mercaptopurine which are cancer chemotherapy drugs; therefore back off dose x4

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16
Q

febuxostat

A

Used in Chronic Gout

nonpurine xanthine oxidase inhibitor

liver function abnormalities, diarrhea, nausea

Does have potential interaction

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17
Q

probenecid

A

Used in Chronic Gout

uricosuric agent, inhibits uric acid renal tubular reabsorption

developed to inhibit renal tubular secretion of penicillin

multiple drug interactions by blocking renal secretion

Need a functional kidney. Will not work in patients with kidney failure. Effects secretion of many organic ions, thus block elimination of other drugs, too.

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18
Q

rasburicase

A

Used in Chronic Gout

recombinant urate oxidase that oxidizes uric acid intomsoluble and inactive metabolite allantoin
used to manage plasma uric acid levels in pediatric patients receiving chemotherapy (for leukemia, lymphoma, etc.)
therapeutic efficacy may be limited by production of antibodies against drug

Oxidizes UA. Makes it more soluble

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19
Q

pegloticase

A

recombinant mammalian uricase coavalently attached to
methoxy plolethylene glycol (mPEG) to prolong
circulating half-life and diminish immunogenic response

treatment of refractory chronic gout

Same as rasburicase, but has pegalated group in order to extend half life

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20
Q

glucocorticoids

A

prednisone main player in immunosuppresive use of glucocorticoids. Stop cytokine production.

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21
Q

cyclosporine/tacrolimus

A

inhibits calcineurin phosphatase activity
decrease dephosphorylation of NFAT; therefore decreasing production of IL-2, 4, 6, etc
T-cell selective
renal toxicity due to accumulation in kidney. Tacrolimus not as much.
hyperglycemia with tacrolimus

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22
Q

sirolimus

A

same family as tacrolimus/cyclosporine
blocks T cell response to cytokines
inhibits a kinase involved in cell-cycle progression
hyperlipidemia as adverse effect

Binds to binding proteins, act on receptor (IL-2) and interfere with IL-2 signal transduction

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23
Q

everolimus

Study These Flashcards
A

closely related to sirolimus; shorter half-life

quicker time to achieve steady-state concentration

24
Q

azathioprine/6-mercaptopurine

Study These Flashcards
A

decrease purine biosynthesis
fraudulent nucleotide
allopurinol interaction

25
mycophenolate mofetil
inhibits inosine monophosphate dehydrogenase decrease de novo purine biosynthesis T and B cell sensitive due to lack of salvage pathway related drug: mizoribine
26
methotrexate
inhibition of DHFR
27
cyclophosphamide
alkylates DNA | effects on rapidly proliferating cells
28
Antithymocyte globulin
Mixture of cytotoxic antibodies to various CD molecules | Adverse effects: fever, chills, hypotension
29
Muromonab CD3
Antibody blocks binding of APC to T-cell Blocks T-cell function Decreases T-cell number Initial stimulation of cytokine release syndrome CD3 is an accessory protein that facilitates the interaction of APC with T Cell Ultimately, begins synthesizing T cells that lack CD-3
30
Daclizumab, Basiliximab
Monoclonal antibodies against IL-2 receptor Blocks IL-2 mediated T-cell activation Potential anaphylactic reactions
31
Cholinergic
Muscarinic M3 receptor: contracts detrusor muscle of bladder relaxes trigone and sphincter Agonism: pro voiding, pro emptying of bladder Antagonist: decrease emptying  
32
Adrenergic
``` Beta 2 relaxes bladder smooth muscle   alpha 1 contracts bladder base, urethral sphincter, prostate   Beta 1 increases renin release ```
33
Cholinergic Activating Agents
Cholinergic activating agents - - bethanechol, neostigmine stimulate bladder emptying treatment of urinary retention problems post surgery only used with no obstructive problems e.g. use post surgery for flaccid bladder
34
tolterodine, oxybutynin, darifenacin, solifenacin
Anti-Cholinergics: relaxes bladder, slows voiding treatment of bladder spasms post surgery or due to inflammation treatment of urinary incontinence
35
Alpha 1 agonists
ephedrine and pseudo ephedrine for treatment of urinary incontinence
36
Alpha 1 antagonists
prazosin, terazosin, doxazosin, tamsulosin treatment of symptoms of urinary obstruction (BPH) tamsulosin greater potency in inhibiting contraction in prostate smooth muscle vs. vascular smooth muscle Relax, help open up flow
37
Acetazolamide
C.A. Inhibitor
38
Methazolamide
C.A. Inhibitor
39
Dichlorphenamide
C.A. Inhibitor
40
Mannitol
Osmotic Agent
41
Isorbide
Osmotic Agent
42
Urea
Osmotic Agent
43
Furosemide
Loop Diuretic
44
Bumetanide
Loop Diuretic
45
Ethacrynic Acid
Loop Diuretic
46
Torsemide
Loop Diuretic
47
Chlorothiazide
Thiazide
48
hydrochlorothiazide
Thiazide
49
Chlorthalidone
Thiazide
50
Indapamide
Thiazide
51
Metolazone
Thiazide
52
Quinethazone
Thiazide
53
Amiloride
Na channel K sparring
54
Triamterene
Na channel K sparring
55
Spironolactone
MR Antagonist K sparring
56
Eplerenone
MR Antagonist K sparring

Renal (1 decks)

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