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Flashcards in Renal Pharm Deck (43):
1

pharmacokinetics+ therapuetic effect colchincine

oral

6-12 hour admin

pain relief at 18hr, max at 48

 

Reduces inflammation

2

____ favors ionization while ____ disfavors ionization

 

___ percipitates tetany and laryngospasm in Ca deficiency

acidosis favors ionization while alkalosis disfavors ionization

 

hyperventilation percipitates tetany and laryngospasm in Ca deficiency

2

factors underlying increased PTH in secondary hyperparathyroidism

decreased calcitriol production (vit D3)

decreased serum Ca

increased serum phos

3

pharmocokinetics Epoetin

IV or subq (better response)

half life 4-6 hours

2-3times/week

4

emerging antiapoptotic drugs

caspase inhibitors

minocycline (antibiotic)

4

signs of 1,25 hydroxy Vita D def in CKD

fractures (esp elderly) 

hyperparathyroidism

4

first generation bisphosphate (simpler side change)

second gen (amino or ntirogenous side chain)

third gen

eidronate+tiludronate

2: Pamidronate, aldedronate, ibadronate

3 - Risedronate, Zoledronate

(ET PAI RZ)

4

mechanism bisphosphates

pyrophosphate analogs

bind hydroxyapatite crystals in bone matrix > inhbit resorption

5

important consideration of calcitriol analogs in kidney disease

ergocaliferol, alfacalcidol or calcitriol must be activated in kidney via 1-a activation

 

must used active form

6

side effects Bisphosphates

GI, abdmonial pain 

osteonecrosis of jaw (IV)

7

drug interactions xanthine oxidase inhibitors allopurinol febuxostat

inhibit metabolism of azathioprine

8

emerging vasodilators

fenoldompam (dopamine)

ANP

(prior to event (thoracic surgery))

9

benefits of renin-angiotensn inhbitors in CKD

reduced progression of albuminuria

reduced progression of GFR decline

reduced risk of ESRD

10

indications, bisphosphates

hypercalcemia

11

side effects of calcitriol+vitamin D analogs

excessive dosing > hypercalcemia

12

bisphosphate that can supress bone absorption for up to a year (all other have weekly admin)

Zoldondrate

12

xanthine oxidase inhibitors for gout

Allopurinol (purine)

Febuxostat (non-purine

 

14

emerging anti inflammatory drugs

adensoine - a2a agonist

phosphatidyserine binding protein

15

mechanism ruasburicase, indication

recombinate version of urate oxidase

 

primarily used as prophylaxis in chemo, also for CKD

16

emerging growth factor drugs

recombinant EPO

17

therapeutic effect of EET analogs

protect kidney from HTN

18

drug classes to minimize proteinuria in diabetic nephropathy

ACEi and ARB

20

therapeutic mechanism Calcitriol and Vitamin D analogs

increase synth of Ca channels+calbindin carrier protein

bind cytoplasmic VitD receptor > promotes endocytoic capture of calcium and transport across duodenal mucosa

also

enhances renal tubular reab of Ca

enhances recruitment+dif of osteoclast preccursors for remodeling

21

side effects phosphate binders

GI

hypercalcemia

22

due to high PTH  levels in CKD, transplant patients may experience

hypercalcemia

23

reduced Ca and increased phosphate in kidney disease lead to

secondary parathyroidism

(metabolic bone disease, soft tissue calcifications)

24

symptoms of enemia

fatigue 

decreased cognition

25

half life of intra-musc or SubQ injection of calcitonin

20 minutes

(but since hormone, lasting effects)

25

side effects colchincine

GI toxicity

rash

27

kidney failure leads to decreased renal excretion of phosphate and diminished production of

calitriol

28

impact on Ca levels of hypoalbuminemia

no decrease in Ca concentration

30

normal plasma Ca

9-11mg/dl

31

side effects Rasburicase

Fever

Hypersensitivity

hemolysis (due to hydrogen peroide as by proudct of allantoin)

32

emerging anti sepsis drugs

insulin

34

calcitonin produced by

parafollicular cells of thyroid

35

calcitriol and vitamin D analogs

ergocaliferol

alafacalcidol

paricalcitol

36

side effects Calcitonin

facial flushing

headache/dizziness

GI

Taste disturbance

37

side effects EPO

headache

flu like symptoms early in treatment

HTN

thrombosis and ateriovenous shunts

pure red cell abx rxn in subQ use

39

phosphate binders

calcium carbonate

calcium acetate

lanthanum carbonate

sevelamer (aluminum free)

 

40

hormones regulating plasma calcium

parathormone

calcitonin

calcitriol (active vit D)

41

% of filtered uric acid load that is excreted

8-12%

42

side effect xanthine oxidase inhibitors allorpurinol

febuxostat

GI

acute gout

hypersensitivity (esp in renal disease pt)

43

halmark of secondary hyperparathyroidism

increased PTH