Kidney disorders Flashcards
(14 cards)
NSAIDs (Aspirin, Ibuprofen, Naproxen)
-Can impair kidney function so monitor BUN and Cr
-use acetaminophen (Tylenol) or opioids if needed for impaired kidney patients
MOA:
-inhibition of cyclooxygenase (COX)
-inhibition of COX-1: decreased platelet aggregation and kidney damage
-inhibition of COX-2: decreased inflammation, fever, and pain
Complications:
-kidney issues: decrease urine output, fluid retention, increase BUN and creatinine levels
Furosemide
MOA: Action in the Loop of Henle to induce diuresis
Complications: hypotension, ototoxicity, hypokalemia, electrolyte imbalances
-interacts with a lot of drugs
Hydrochlorothiazide
thiazide diuretic
MOA: Work in the early distal convoluted tubule
Complications: dehydration and electrolyte imbalances (hypokalemia and hyperglycemia)
Spironolactone
MOA: Potassium-sparing diuretics block aldosterone
Complications: hyperkalemia (monitor ECG)= switch diuretic or admin insulin
-ACEs, ARBs, or Direct renin inhibitors + spironolactone = hyperkalemia
-Endocrine effects: good for PCOS to counteract hyperandrogenism
Mannitol
osmotic diuretic
MOA: Reduce Intracranial pressure (ICP) and intraocular pressure (By drawing fluid back into the vascular and extravascular spaces)
Complications: HF, pulmonary edema, rebound increased ICP, Fluid and electrolyte imbalances (metabolic acidosis)
Captopril
ACEs
MOA: Reduce production of Angiotensin II by blocking conversion from A I to A II and increasing levels of bradykinin, which leads to: vasodilation, excrete Na, water, and retain K
Complications: 1st dose orthostatic hypotension, cough, hyperkalemia, rash, altered taste, angioedema, neutropenia
Losartan
ARBs
MOA: Block A II in the body causing vasodilation and excretion of Na and water
Complications: Angioedema, fetal injury, hypotension, dizziness, lightheadedness
Acetaminophen
MOA: slows production of prostaglandins in CNS
-contraindicated for those with kidney impairment
Opioids
MOA: activation of mu receptors produce analgesia, resp depression, euphoria, and sedation. Activation of kappa receptor produces analgesia, sedation, and decrease GI motility
Complications: orthostatic hypotension, urinary retention
Antibiotics that are nephrotoxic
Aminoglycosides:
-MOA: disrupts protein synthesis
-acute tubular necrosis
Vancomycin:
-MOA: cell wall synthesis inhibitors
-renal toxic, major toxicity is renal failure
Fluoroquinolones:
-MOA: inhibit enzyme for DNA replication
-low doses to those with impaired kidney function
TMP-SMX (sulfonamides and trimethoprim):
-MOA: prevents folic acid synthesis for DNA in bacteria
-crystalluria: causing irritation and obstruction causing AKI
-hyperkalemia
Beta-lactams (PCN and Cephalosporin):
-MOA: destroy cell wall synthesis
-renal impairment, renal insufficiency
Erythropoietic growth factors: Epoetin-alfa
-helps anemia related to CKD
MOA: acts on bone marrow to increase RBC production
Complications: hypertension
SGLT-2 inhibitors- Canagliflozin
MOA:
-for diabetes and kidney issues to help excrete glucose
-prevents reabsorption of glucose by the kidneys
Complications: cystitis, candidiasis, polyuria, hypotension
Antifungals: Amphotericin
MOA: cause fungal cell death
Complications: nephrotoxicity, electrolyte imbalances
Sodium bicarbonate
MOA: helps remove acids by buffering H ions, can be an antacid like Alka-Seltzer, used for many things like metabolic acidosis
Complications: taken with milk can cause renal insufficiency, hypercalcemia, and metabolic acidosis
-taken with ciprofloxacin can decreased solubility of these drugs leading to crystalluria and nephrotoxicity
