Renal Pharmacology

Question 1

drug with high therapeutic index and low toxicity?

Answer 1

benzylpenicillin

Question 2

drugs with narrow therapeutic index? (4)

Answer 2

gentamicin
digoxin
lithium
tacrolimus

Question 3

pharmacokinetic effects?

Answer 3

reduced GFR results in reduced clearance

protein binding is reduced = more free drug

Question 4

overcoming pharmacokinetic effects?

Answer 4

reduce dosage
increase dosage interval
monitor blood levels

Question 5

pharmacodynamic effects, renal disease?

Answer 5

BBB becomes more permeable, brain more sensitive
circulatory volume may be reduced causing antihypertensive sensitivity
increased tendency to bleed

Question 6

what do we want ideally in renal impairment patients?

Answer 6

drugs which have a high therapeutic index and are metabolised by the liver with the production on non-toxic metabolites

Question 7

hypertension drugs in renal disease?

Answer 7

ACEis recommended

TT diuretics may precipitate gout