Pharmacology - Drugs and the kidney Flashcards
(38 cards)
how the body affects a drug is known as
a.pharmacokinetics
b.pharmacodynamics
a.pharmacokinetics
how a drug affects the body is known as
a.pharmacokinetics
b.pharmacodynamics
b.pharmacodynamics
which of these drugs is less effective in renal impairment
a.thiazide diuretics
b.loop diuretics
c.trimethoprim
a.thiazide diuretics
give loop instead (cautiously)_
which of these drugs has increased efficacy in renal impairment
a. digoxin
b.potassium sparing diuretics
c.opiods
d.nitrofurantoin
c.opiods
opiods and sedatives have increased effect of the drug in renal impairment
which of these drugs can cause neuropathy due to increased toxicity in renal impairment
a.digoxin
b.potassium sparing diuretics
c.nitrofurantoin
d.tetracyclines
e.metformin
c.nitrofurantoin
^ all of the above have increased toxicity in renal impairment but expressed as different symptoms
which of these drugs can cause increased protein breakdown due to increased toxicity in renal impairment
a.digoxin
b.potassium sparing diuretics
c.nitrofurantoin
d.tetracyclines
e.metformin
d.tetracyclines
which of these drugs can cause lactic acidosis due to increased toxicity in renal impairment
a.digoxin
b.pottasium sparing diuretics
c. nitrofurantoin
d.tetracyclines
e.metformin
e.metformin
patient on drugs which are potentially nephrotoxic , have acute kidney injury (decreased renal perfusion) accompained by vomiting and diarrhoea what action should be taken
a.drugs stopped , give IV fluids
b.increase dosage of drugs following symptoms subsiding
c. give IV fluids
a.drugs stopped , give IV fluids
a reduction in blood perfusion of the kidney is what type of acute kidney injury
a.pre renal
b.intrinsic
c.post renal
a.pre renal - blood supply to the kidney
which of these drugs is not associated with pre renal impairment
a.diuretics
b.ACEi/ARBs
c.NSAIDS
d.opiods
e.ciclosporin (DMARD)
d.opiods
all others above are associated
and radio contrast media is also associated with pre renal impairment
aminoglycosides, amphotericin B(anti fungal) , antiplatelets,DMARDS, lithium,NSAIDS and radio contrast media are associated with which type of acute kidney injury
a,pre renal
b.intrinsic
c.post renal
b.intrinsic - in the kidney itself
anti platelets eg clopidogrel are not usually stopped as they are usually essential
aciclovir and methotrexate are associated with which type of acute kidney injury
a.pre renal
b.intrinsic
c.post renal -stones
d.post renal - retroperitoneal fibrosis
c.post renal -stones
atenolol and ergot derivatives are associated with which type of acute kidney injury
a.pre renal
b.intrinsic
c.post renal -stones
d.post renal - retroperitoneal fibrosis
d.post renal - retroperitoneal fibrosis
rare inflammatory disorder in which abnormal formation of fiber-like tissue (fibrosis) occurs behind the membrane that lines the cavity of the abdomen (peritoneum)
specific drugs to look out for and STOP in acute kidney injury
Nifty
Ant eaters
Dont
Like
Gnawing
More
Mounds
For food
NSAIDS
ACE/ARBs
digoxin
lithium
gentamicin
methotrexate
metformin
flozins- sglt2 inhibitors
which drugs can cause interstitial nephritis
a.NSAIDS
b.ACE/ARBs
c.digoxin
d.lithium
e.gentamicin
a.NSAIDS
must ask about over the counter use
what type of kidney problem are ACEi/ARBs contraindicated in
a.renal artery stenosis
b.interstitial nephritis
c.kidney stones
a.renal artery stenosis
ACE/ARBs used to vasodilate the efferent arteriole and reduce intraglomerular pressure and therefore reduce proteinuria
BUT
may be associated with renal function detiorioration if pre renal problem as blood flow to the kidney will be reduced further
withheld when patient is acutely unwell - sick day
which of these drugs is used to reduce intraglomerular pressure and therefore reduce proteinuria
a.NSAIDS
b.ACEi/ARBS
c.digoxin
d.lithium
e.gentamicin
b.ACEi/ARBS
patient on ACE/ARBS and is acutely unwell what action should be done
a.withhold drugs for 1-2 days
b.stop drugs for continued period of time
c.increase dosage
d.give IV fluids
a.withhold drugs for 1-2 days
sick day
when diuretics are combined with other diuretics what adverse effect is more likely
a.electrolyte disturbances
b.nephrotoxicity
c.impaired diuresis
d.hypotension
e.lithium toxicity
a.electrolyte disturbances
when diuretics are combined with aminoglycosides what adverse effect is more likely
a.electrolyte disturbances
b.nephrotoxicity
c.impaired diuresis
d.hypotension
e.lithium toxicity
when diuretics are combined with NSAIDS what adverse effect is more likely
a.electrolyte disturbances
b.nephrotoxicity
c.impaired diuresis
d.hypotension
e.lithium toxicity
c.impaired diuresis
when diuretics are combined with ACEi/vasodilators what adverse effect is more likely
a.electrolyte disturbances
b.nephrotoxicity
c.impaired diuresis
d.hypotension
e.lithium toxicity
d.hypotension
which diuretics are likely to cause lithium toxicity when co prescribed
a.loop
b.thiazide
c.potassium sparing
d.osmotic
b.thiazides
lithium should be………… in severe renal impairment
a.avoided
b.reduced
c.prescribed
a.avoided
