ACEI (Captopril) Renal Scan Flashcards

1
Q

RVH

A

renovascular hypertension

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2
Q

what causes RVH?

A

renal artery stenosis. (RAS)

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3
Q

indications for a ACEI renal exam

A
  • severe hypertension resistant to meds
  • abrupt or recent onset of hypertension
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4
Q

mechanism of Captopril

A

if the pathway is blocked, the ACEI will cause the GFR to drop

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5
Q

dose of Capoten

A

25-50 mg

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6
Q

method of admin for Captopril

A

PO, chew and swallow 60 min prior to imaging

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7
Q

patient prep

A
  • off ACEI for 1 week
  • well hydrated and off diuretics
  • off Ca channel blockers
  • NPO 4 hrs
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8
Q

explain 1 day protocol

A
  • baseline done first with 37 MBq
  • wait an hour
  • Captopril scan with 370 MBq
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9
Q

explain the 2 day protocol

A
  • Captopril first
  • normal? don’t need baseline
    dose for both days = 90-370 MBq
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10
Q

how often are we monitoring the patient’s BP?

A

every 15 mins for the next hour (prior to imaging)

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11
Q

Lasix can’t be administered during the time RP is given for a Captopril study. T/F

A

False.
can be given to ensure clearance

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12
Q

alternative to Captopril

A

Enalaprilat (Vasotec)

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13
Q

method of admin for Vasotec

A

IV infusion, over 3-5 mins

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14
Q

dose of enalaprilat

A

40 ug/kg, max 2.5 mg

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15
Q

instead of waiting for an hour after Captopril admin, when do we inject the RP when using Vasotec?

A

15-20 mins after admin.

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16
Q

BP monitored every ____ when using enalaprilat

A

5 mins

17
Q

negative for RAS/RVH

A

renogram curve looks the same with or without ACEI

18
Q

how will the renogram look if we use MAG3 and the pt has RAS?

A
  • uptake and secretion is okay
  • excretion will be decreased due to decreased GFR
19
Q

how will the renogram look if we use DTPA and the pt has RAS?

A
  • fall in peak function
  • decrease uptake and excretion
  • decrease in relative function (-10% from baseline)