renal Flashcards
(25 cards)
nephron is what of the kidney
functional unit
what does nephron control and reabsorb
controls: blood vol/pressure
reabsorbs: Na and H2O
in the glomerulus (filtering unit) what do the afferent and efferent arterioles do
afferent: blood INTO glom
efferent: blood EXITS gloom
what med works in the proximal tubule
SGLT2
what things that are filtered out, will be reabsorbed back in the proximal tubule
NA, Cl, Ca, Water and glucose
what med works in the loop of henle
loop diuretics
what is the moa of loops
inhibit NaK pump in ascending so dec Na reabsorption
what do the descending and ascending limbs of the loop of henle reabsorb
descending: H20
ascending: Na and Cl
what med works in the distal tubule
thiazides (weaker diuretic)
what is the moa of thiazides
inhibit NaCl pump, inc Ca reabsorption (retains more so good for bones)
what meds work in the collecting duct
sprinolactone and eplerenone
what does aldosterone do in the collecting duct
inc Na and h20 reabsorption , dec K reabsorption (inc K in blood)
what drugs cause kidney disease (VANCC LOOPs TAP PAC
vanco
aminoglycosides
nsaids
cisplatin
cyclosporine
loops
tacro
amp b
polmyxins
contrast
what is the first line med to delay progression of CKD
ACE/ARB
*if Scr inc >30% then STOP
what are the complications of CKD
inc Phos
dec vit D and Ca (kidneys cant activate vit D when diseased)
dec erythropoietin
what is the tx for hyperphos
restrict diet (choc, cola, dairy, nuts)
phos binders (all TID, bind po4 in food and send it out via poop)
what happens if you miss a dose of phos binders
skip until next meal/snack
what is the first line for hyperphos
Ca based
what are the other options
-Al based (last line)- do a couple days of tx w Al bc potent then switch to Ca
-Al and Ca free (iron based)–sevelamer and lanthanum
what DDI are there with phos binders and what should you do
levo
quinolones and tetra
oral bisphos
*sep admin
what are the tx options for vit d def
vit d analogs
calcimimetics
Vit D analog and MOA
calcitriol (active form of D3)
-inc Ca absorption in gut, inhibit PTH secretion
-HYPERCa!!
calcimimetics and moa
cinacalet
-act as Ca sensing receptor on PT gland
-HYPOCa!!
what is the treatment oof hyperkalemia
- stabilize heart (prevent arrhythmias)
-Ca gluc - move K intracellularly
-insulin w dex
-sodium bicarb
-albuterol - remove it
-furosemide
-binding agents (patriomer)
-dialysis
