Nephrotoxic Drugs

Question 1

PreRenal Azotemia

Answer 1

A ACEI
D DIURETICS
R RADIOCONSTANT AGENTS
I IMMUNOSUPPRESSANTS
A ANTICOAGULANT & Thrombolytics
N NSAIDS

Question 2

Acute tubular necrosis

Answer 2

A aminoglycosides eg gentamicin
F foscarnet
A ampho B
C cisplatin
T Tenofovir

Question 3

Acute interstitial nephritis- renal (intrinsic) azotemia
these drugs cause a HSR/inflammation

Answer 3

H2P2NCQ
H2 receptor antagonists
P proton pump inhibitors
P penicillin eg methicillin
N NSAIDS
C Cephalosporin
Q quinolones

Question 4

Glomerular diseases & RPGN

Answer 4

D D. Penicillin
H hydralizine
P pyrothiouracil

Question 5

Post Renal Azotemia

Answer 5

A acyclovir
I indanavir
M methotrexate
S sulfonamide

Question 6

Rhabdomyolysis

Answer 6

S statin and fibrates
A antipsychotic drugs
Z zidavudine
A amphetamines
A azathioprine
L lithium

Question 7

How do diuretics cause pre renal azotemia?

Answer 7

they decrease BP, and decrease RBF
the kidney auto regulates and continues to decrease RBF which eventually leads to kidney failure

Question 8

How do arterial vasodilators cause pre renal azotemia?

Answer 8

They cause hypotension and decrease RBF and if the hypotension is not corrected they lead to failure

Question 9

What is the mechanism by which NSAIDs cause pre-renal azotemia?

Answer 9

they decrease GFR and RBF
NSAIDs inhibits prostaglandins causing vasoconstriction of the afferent arterioles which lead to decrease
blood flow to the glomerulus.

prostaglandins normally would dilate the afferent which increases GFR and RBF

Question 10

Mechanism by which ACE inhibitors Cause Pre-Renal Azotemia

Answer 10

ACE inhibitors causes vasodilation of the efferent arterioles which lead to decrease intraglomerular pressure and decrease GFR.

ACE would normally constrict the efferent, and increases GFR and decrease RBF and increase FF. The increase in GFR is due to increase hydrostatic pressure.

Question 11

Mechanism by which anticoagulants and thrombolytics Cause Pre-Renal Azotemia

Answer 11

Anticoagulants and thrombolytic agent cause dissolution of thrombus into small thrombi that can lead to embolization of the renal arteries causing renal ischemia, necrosis and infarction.

Question 12

Mechanism by which Aminoglycosides Cause Acute Tubular Necrosis

Answer 12

Aminoglycosides accumulate in proximal tubular cell lysozymes causing acute tubular necrosis