Renal Flashcards
(135 cards)
1
Q
Drug class for Sevelamer
A
nonhormonal regulators of mineral homeostasis
2
Q
MoA for Sevelamer
A
non-absorbed phosphate binder prevents absorption promoting excretion
3
Q
Indications for Sevelamer
A
hyperphosphatemia
4
Q
SE/ADRs for Sevelamer
A
N/V/D, constipation, rash
5
Q
Contra-indications for Sevelamer
A
hypophosphatemia, bowel obstruction, dysphagia, bowel disorders, may decrease Vit D, E, K, folate absorption
6
Q
Dx-Dx interactions for Sevelamer
A
may decrease absorption of Ciprofloxin, anti-seizure drugs, anti-arrhythmic drugs
7
Q
Monitoring for Sevelamer
A
Ca+, PO4, Ca-P product
8
Q
Drug class for Cinacalcet
A
nonhormonal regulator of mineral homeostasis
9
Q
MoA for Cinacalcet
A
reduces PTH secretion by sensitizing PT gland Ca+ receptors (mimics action of Ca+ at receptor) lowering Ca+ & phosphorous levels
10
Q
Indications for Cinacalcet
A
elevated serum PTH, Ca+, Ca-P product
11
Q
SE/ADRs for Cinacalcet
A
hypocalcemia
12
Q
Contra-indications for Cinacalcet
A
hypocalcemia
13
Q
Dx-Dx interactions for Cinacalcet
A
anti-seizure meds
14
Q
Monitoring for Cinacalcet
A
serum Ca+, PO4, Ca-P product
15
Q
Drug class for HCTZ
A
nonhormonal regulator of mineral homeostasis
16
Q
MoA for HCTZ
A
Na-Cl symporter inhibition in the DCT increasing Na & Cl excretion max 5% of filtered NaCl
17
Q
Indications for HCTZ
A
HTN, edema in nephrotic syndrome, lithium induced diabetes insipidous (off-label_
18
Q
SE/ADRs for HCTZ
A
rare vertigo, anorexia, nausea, photosensitivity,QT prolongation, hypokalemia
19
Q
Contra-indications for HCTZ
A
hypersensitivity, sulfa sensitivity
20
Q
Dx-Dx interactions for HCTZ
A
BBs increase risk of hyperglycemia, may decrease renal excretion of Li, NSAIDs
21
Q
Monitoring for HCTZ
A
serum K+, glucose, BP
22
Q
Drug class for CaCO3
A
nonhormonal regulator of mineral homeostasis
23
Q
MoA for CaCO3
A
bind to phosphorous in GI tract & excreted
24
Q
Indications for CaCO3
A
CKD w/ hyperphosphatemia
25
SE/ADRs for CaCO3
constipation, hypercalcemia
26
Contra-indications for CaCO3
hypercalcemia
27
Dx-Dx interactions for CaCO3
antagonizes Verapamil, Thiazides increases Ca+, decrease Atenolol absorption
28
Monitoring for CaCO3
serum Ca+, PO4, Ca-P product
29
Drug class for Calcitrol
nonhormonal regulator of mineral homeostasis
30
MoA for Calcitrol
up-regulates Vit D receptor of PT gland decreasing gland hyperplasia & PTH synthesis
31
Indications for Calcitrol
reduction of PTH levels; hypocalcemia in ESRD
32
SE/ADRs for Calcitrol
anorexia, constipation, arrhythmias, HTN
33
Contra-indications for Calcitrol
hypercalcemia, Vit D toxicity
34
Dx-Dx interactions for Calcitrol
may increase risk of digitalis toxicity, steroids may decrease Ca absorption
35
Monitoring for Calcitrol
BUN, eGFR, Ca+, PO4, Ca-P product, PTH levels
36
Drug class for Erythropoetin
erythropoesis stimulants
37
MoA for Erythropoetin
stimulates erythroblasts to proliferate & differentiate into normoblasts, then reticulocytes
38
Indications for Erythropoetin
anemia in CKD
39
SE/ADRs for Erythropoetin
fever, dizziness, pruritis, increased BP, thromboembolic events, edema, DVT
40
Contra-indications for Erythropoetin
caution w/ high BP (greater than 180/100), seizure hx, hypersensitivity to human albumin
41
Dx-Dx interactions for Erythropoetin
none
42
Monitoring for Erythropoetin
transferrin saturation, serum ferritin, BP, Hgb, serum chemistries, CBC
43
Drug class for MgCL
electrolyte supplement
44
MoA for MgCL
supplement
45
Indications for MgCL
hypomagnesemia
46
SE/ADRs for MgCL
diarrhea
47
Contra-indications for MgCL
elevated serum Mg
48
Dx-Dx interactions for MgCL
none
49
Monitoring for MgCL
serum Mg, K+, Ca+
50
Drug class for KCL
electrolyte supplement
51
MoA for KCL
electrolyte supplement
52
Indications for KCL
hypokalemia
53
SE/ADRs for KCL
rash, hyperkalemia, caustic to mucosa in esophagus
54
Contra-indications for KCL
severe renal impairment, esophageal disorders
55
Dx-Dx interactions for KCL
none
56
Monitoring for KCL
serum K+, glucose
57
Drug class for HCTZ, Chlorthalidone, Metolazone, Indapamide
diuretics: thiazides
58
MoA for HCTZ, Chlorthalidone, Metolazone, Indapamide
Na-Cl symporter inhibition in the DCT increasing Na & Cl excretion, max 5% of filtered Na
59
Indications for HCTZ, Chlorthalidone, Metolazone, Indapamide
HTN, edema in nephrotic syndrome, litium induced diabetes insipidus (off label)
60
SE/ADRs for HCTZ, Chlorthalidone, Metolazone, Indapamide
rare vertigo, anorexia, nausea, photosensitivity, QT prolongations, hypokalemia
61
Contra-indications for HCTZ, Chlorthalidone, Metolazone, Indapamide
hypersensitivity, sulfa sensitivity
62
Dx-Dx interactions for HCTZ, Chlorthalidone, Metolazone, Indapamide
BBs increase risk of hyperglycemia, may decrease renal excretion of Li, NSAIDs
63
Monitoring for HCTZ, Chlorthalidone, Metolazone, Indapamide
serum K+, glucose, BP
64
Drug class for Furosemide
loop diuretic
65
MoA for Furosemide
inhibits Na/K/Cl symporter in TAL of loop & distal tubule
66
Indications for Furosemide
edema sec to CHF, renal failure, liver failure
67
SE/ADRs for Furosemide
hypotension, dehydration, hyperglycemia, decrease then increase serum uric acid, electrolyte abnormalities, cholestatic jaundice
68
Contra-indications for Furosemide
sulfa sensitivity
69
Dx-Dx interactions for Furosemide
increase impact of anti-hypertensives, lithium; corticosteroids increase Furosemide impact
70
Monitoring for Furosemide
serum electrolytes, BUN, CrCl
71
What is the outpatient target body weight loss/day for Furosemide?
about 2lbs wt loss/day
72
Drug class for Torsemide
loop diuretic
73
MoA for Torsemide
inhibits Na/K/Cl symporter in TAL loop & distal tubule
74
indications for Torsemide
edema of cardia, renal, hepatic failure; HTN
75
SE/ADRs for Torsemide
constipation, diarrhea
76
Contra-indications for Torsemide
sulfa sensitivity, anuria
77
Dx-Dx interactions for Torsemide
other K+ wasting drugs
78
Monitoring for Torsemide
serum K+, BP, daily wt, eGFR
79
PG category for Torsemide
avoid
80
Drug class for Ethacrynic Acid
loop diuretic
81
MoA for Ethacrynic Acid
inhibits Na/K/Cl cymporter in TAL of loop & distal tubule
82
Indications for Ethacrynic Acid
edema sec to CHF, renal failure, liver failure
83
SE/ADRs for Ethacrynic Acid
hypotension, dehydration, hyperglycemia, decrease then increase serum uric acid, electrolyte abnormalities, jaundice
84
Contra-indications for Ethacrynic Acid
hypersensitivity, hx severe watery diarrhea w/ Ethacrynic acid
85
Dx-Dx interactions for Ethacrynic Acid
increase impact of anti-hypertensives, lithium; corticosteroids increase diuretic impact
86
Monitoring for Ethacrynic Acid
serum electrolytes, BUN, CrCl, BP
87
Drug class for Spironolactone
potassium sparing diuretic: aldosterone antagonist
88
MoA for Spironolactone
competitive antagonist at aldosterone mineralcorticoid receptors in DCT increasing NaCl & water loss but retention K+
89
Indications for Spironolactone
edema from excess aldosterone secretion, hypokalemia, HF
90
SE/ADRs for Spironolactone
gynecomastia, hyperkalemia, agranulocytosis, liver toxicity
91
Contra-indications for Spironolactone
hypersensitivity, anuria, hyperkalemia
92
Dx-Dx interactions for Spironolactone
K+ supplements, K+ retaining drugs
93
Monitoring for Spironolactone
serum electrolytes, BUN, CrCl
94
Drug class for Eplenerone
potassium sparing diuretic: aldosterone antagonist
95
MoA for Eplenerone
competitive antagonist at aldosterone mineralcorticoid receptors in DCT increasing NaCl & water loss w/ retention K+
96
Indications for Eplenerone
edema from excess aldosterone secretion, hypokalemia, HF
97
Contra-indications for Eplenerone
hyperkalemia
98
Contra-indications for Eplenerone
hyperkalemia, CrCl less than 50mL/min
99
Dx-Dx interactions for Eplenerone
other K+ sparing diuretics
100
Monitoring for Eplenerone
electrolytes, BUN, CrCl, BP
101
Drug lass for Amiloride
potassium sparing
102
MoA for Amiloride
direct inhibitor of Na+ influx in DCT & CCT
103
Indications for Amiloride
hypokalemia, edema sec to CHF, cirrhosis
104
SE/ADRs for Amiloride
HA, N/V/D, dyspnea, hyperkalemia, impotence
105
Contra-indications for Amiloride
hypersentivity, serum K+ greater than 6.5meq/L, renal failure
106
Dx-Dx interactions for Amiloride
other K+ retaining meds
107
Monitoring for Amiloride
serum electrolytes, BUN, CrCl
108
Drug class for Triamterene
adjunct K+ sparing
109
MoA for Triamterene
direct inhibitor of Na+ influx in DCT & CCT
110
Indications for Triamterene
hypokalemia, edema sec to CHF, cirrhosis
111
SE/ADRs for Triamterene
hypotension, edema, constipation, dyspnea, hyperkalemia
112
Contra-indications for Triamterene
hypersensitivity, hyperkalemia, CrCl less than 10mL/min
113
Dx-Dx interactions for Triamterene
other K+ retaining meds
114
Monitoring for Triamaterene
serum electrolytes, BUN, CrCl
115
Drug class for Mannitol
Osmotic
116
MoA for Mannitol
Osmosis producing increased water loss
117
Indications for Mannitol
Reduction of intracranial or intraocular pressure, rhabdomyolysis
118
SE/ADRs for Mannitol
HA, N/V, extra cellular fluid expansion, dehydration, hyperkalmia, hypernatremia, pulmonary edema, CHF
119
Contra-indications for Mannitol
Renal failure, lack of response to test dose
120
Dx-Dx interactions for Mannitol
None
121
Monitoring for Mannitol
Serum electrolytes, BUN, CrCl
122
Drug class for Acetozolamide
carbonic anhydrase inhibitor
123
MoA for Acetozolamide
reversibly blocks carbonic anhydrase in PCT maintaining NaHCO3 in tubule lumen resulting in diuresis
124
Indications for Acetozolamide
glaucoma, altitude sickness
125
SE/ADRs for Acetozolamide
flushing, ataxia, electrolyte imbalance, confusion, convulsions, SJS
126
Contra-indications for Acetozolamide
sulfa sensitivity
127
Dx-Dx interactions for Acetozolamide
may increase levels of anti-hypertensives, anticonvulsants, alcohol
128
Monitoring for Acetozolamide
serum electrolytes, BP
129
What drug interferes with secretion of loop diuretics?
NSAIDs
130
Furosemide, Bumetadine, and Torsemide are all sulfa drugs and have the potential for large losses of what ions in the urine?
K+, Mg++
131
How is Mannitol administered?
IV for systemic effect
132
Mannitol is not metabolized, it is ____?
filtered via glomerulus
133
Pathophysiology of NSAIDs
inhibit PGE production resulting in unopposed afferent renal arteriole AT2 impact -> vasoconstriction; interferes w/ PGE modulated inhibition of Na & Cl re-absorption
134
Who is at risk with NSAIDs?
CHF, CKD, hypovolemia, hepatic cirrhosis
135
What is the renal impact of Cyclosporine
causes renal vasoconstriction
