Renal Pharm

Question 1

pharmacokinetics+ therapuetic effect colchincine

Answer 1

oral

6-12 hour admin

pain relief at 18hr, max at 48

Reduces inflammation

Question 2

____ favors ionization while ____ disfavors ionization

___ percipitates tetany and laryngospasm in Ca deficiency

Answer 2

acidosis favors ionization while alkalosis disfavors ionization

hyperventilation percipitates tetany and laryngospasm in Ca deficiency

Question 2

factors underlying increased PTH in secondary hyperparathyroidism

Answer 2

decreased calcitriol production (vit D3)

decreased serum Ca

increased serum phos

Question 3

pharmocokinetics Epoetin

Answer 3

IV or subq (better response)

half life 4-6 hours

2-3times/week

Question 4

emerging antiapoptotic drugs

Answer 4

caspase inhibitors

minocycline (antibiotic)

Question 4

signs of 1,25 hydroxy Vita D def in CKD

Answer 4

fractures (esp elderly)

hyperparathyroidism

Question 4

first generation bisphosphate (simpler side change)

second gen (amino or ntirogenous side chain)

third gen

Answer 4

eidronate+tiludronate

2: Pamidronate, aldedronate, ibadronate

3 - Risedronate, Zoledronate

(ET PAI RZ)

Question 4

mechanism bisphosphates

Answer 4

pyrophosphate analogs

bind hydroxyapatite crystals in bone matrix > inhbit resorption

Question 5

important consideration of calcitriol analogs in kidney disease

Answer 5

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

must used active form

Question 6

side effects Bisphosphates

Answer 6

GI, abdmonial pain

osteonecrosis of jaw (IV)

Question 7

drug interactions xanthine oxidase inhibitors allopurinol febuxostat

Answer 7

inhibit metabolism of azathioprine

Question 8

emerging vasodilators

Answer 8

fenoldompam (dopamine)

ANP

(prior to event (thoracic surgery))

Question 9

benefits of renin-angiotensn inhbitors in CKD

Answer 9

reduced progression of albuminuria

reduced progression of GFR decline

reduced risk of ESRD

Question 10

indications, bisphosphates

Answer 10

hypercalcemia

Question 11

side effects of calcitriol+vitamin D analogs

Answer 11

excessive dosing > hypercalcemia

Question 12

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

Answer 12

Zoldondrate

Question 12

xanthine oxidase inhibitors for gout

Answer 12

Allopurinol (purine)

Febuxostat (non-purine

Question 14

emerging anti inflammatory drugs

Answer 14

adensoine - a2a agonist

phosphatidyserine binding protein

Question 15

mechanism ruasburicase, indication

Answer 15

recombinate version of urate oxidase

primarily used as prophylaxis in chemo, also for CKD

Question 16

emerging growth factor drugs

Answer 16

recombinant EPO

Question 17

therapeutic effect of EET analogs

Answer 17

protect kidney from HTN

Question 18

drug classes to minimize proteinuria in diabetic nephropathy

Answer 18

ACEi and ARB

Question 20

therapeutic mechanism Calcitriol and Vitamin D analogs

Answer 20

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

Question 21

side effects phosphate binders

Answer 21

GI

hypercalcemia

Question 22

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

Answer 22

hypercalcemia

Question 23

reduced Ca and increased phosphate in kidney disease lead to

Answer 23

secondary parathyroidism (metabolic bone disease, soft tissue calcifications)

Question 24

symptoms of enemia

Answer 24

fatigue decreased cognition

Question 25

half life of intra-musc or SubQ injection of calcitonin

Answer 25

20 minutes | (but since hormone, lasting effects)

Question 25

side effects colchincine

Answer 25

GI toxicity rash

Question 27

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

Answer 27

calitriol

Question 28

impact on Ca levels of hypoalbuminemia

Answer 28

no decrease in Ca concentration

Question 30

normal plasma Ca

Answer 30

9-11mg/dl

Question 31

side effects Rasburicase

Answer 31

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

Question 32

emerging anti sepsis drugs

Answer 32

insulin

Question 34

calcitonin produced by

Answer 34

parafollicular cells of thyroid

Question 35

calcitriol and vitamin D analogs

Answer 35

ergocaliferol alafacalcidol paricalcitol

Question 36

side effects Calcitonin

Answer 36

facial flushing headache/dizziness GI Taste disturbance

Question 37

side effects EPO

Answer 37

headache flu like symptoms early in treatment HTN thrombosis and ateriovenous shunts pure red cell abx rxn in subQ use

Question 39

phosphate binders

Answer 39

calcium carbonate calcium acetate lanthanum carbonate sevelamer (aluminum free)

Question 40

hormones regulating plasma calcium

Answer 40

parathormone calcitonin calcitriol (active vit D)

Question 41

% of filtered uric acid load that is excreted

Answer 41

8-12%

Question 42

side effect xanthine oxidase inhibitors allorpurinol febuxostat

Answer 42

GI acute gout hypersensitivity (esp in renal disease pt)

Question 43

halmark of secondary hyperparathyroidism

Answer 43

increased PTH