Kidney Toxicity Flashcards
(27 cards)
function of renal tubules is highly dependent on what
total epithelial cell integrity
what happens when drugs compromise the total epithelial cell integrity
back-leaking of the renal filtrate and consequent diminished GFR
what happens when cells become detached and aggregate in the tubule or adhere to epithelial cells downstream
tubular obstruction
DRUGS that cause pre renal issues
Diuretics
ACE inhibitors
ARBs
antihypertensive agents
(Perhaps Ren) Died Acing ARBs Annie
drugs that cause vasoconstriction
NSAIDs radiocontrast cyclosporine tacrolimus amphotericin B VAL needs contrast to ambush
drugs that cause Crystalluria
sulfonamides methotrexate acyclovir triamterene protease inhibitors
Crystal, Some might admire Tayshaun Prince
drugs that cause tubular toxicity
aminoglycosides cisplatin vancomycin pentamidine radiocontrast
(A CLEAN VAGINA PROMOTES REPRODUCTION)
drugs that cause endothelial injuries
cyclosporine mitomycin C tacrolimus cocaine conjugated estrogens quinine (CUT MY TALL COKE CON QUESO)
drugs that cause glomerulopathy
penicillamine
NSAIDs
drugs that cause interstitial nephritis
antibiotics
NSAIDs
diuretics
high molecular weight proteins like albumin suggest what
glomerular damage
low mol. wt. proteins like b2microglobulin suggest
proximal tubular damage
long-term exposure to a number of drugs can produce maladaption of the damaged areas with development of what 3 things
glomerulosclerosis
tubular atrophy
interstitial fibrosis
acetaminophen
proximal tubular necrosis: increase BUN and serum creatinine, decreased GFR
NSAIDs inhibit what
prostaglandin synthesis
NSAIDs have what effect on kidneys
vasoconstriction which leads to decreased renal bloodflow and ischemia
chronic consumption of NSAIDs and tylenol can produce
analgesic nephropathy, characterized by interstitial nephritis and papillary necrosis
aminoglycosides cause an increase in the number and size of what
lysosomes
aminoglycosides cause drug-induced inhibition of what
sphingomyelinase and phospholipases, both important lysosome hydrolases
rupture of the lysosomes causes what
exposing the contents of lysosome to cytoplasm, which is toxic
amphotericin B impairs the functional integrity of …which leads to…..
glomerulus, proximal and distal tubules.
leads to decrease in RBF and decrease in GFR
What effect does cyclosporine have on the kidneys
acute reversible renal dysfunction and acute vasculopathy
how does cisplatin cause renal toxicity
through its MOA by inhition of DNA synth. and transport functions
Pts treated with this drug permanently lose 10-30% of their renal function
cisplatin
