CKD Flashcards
1
Q
What are 9 drugs for treating CKD?
A
- Statins
- Aspirin
- Trimethoprim
- Gentamicin
- CCBs
- ACEi
- ARBs
- Dapaglifozin (SGLT2)
- NSAIDs
2
Q
What is the mechanism of action of statins?
A
- Selective, competitive inhibitor of hydroxymethylglutaryl-CoA (HMG-CoA) reductase which is the enzyme responsible for converting HMG-CoA to mevalonate in the cholesterol synthesis pathway
- By reducing hepatic cholesterol synthesis an upregulation of LDL-receptors and increased hepatic uptake of LDL-cholesterol from the circulation occurs
3
Q
What is the mechanism of action of aspirin?
A
- Irreversible inactivation of COX enzyme, prevents oxidation of arachidonic acid to produce prostaglandins
- Reduction of thromboxane A2 in platelets reduces aggregation
- Reduction of PGE2 at sensory pain neurones reduces pain and sensation and in the brain decreases fever
4
Q
What is the mechanism of action of trimethoprim?
A
- Antibiotic which is a direct competitor of the enzyme dihydrofolate reductase
- Inhibits the reduction of dihydrofolic acid to tetrahydrofolic acid (active form) which is a necessary component for synthesising purines required for DNA and protein production
5
Q
What is the mechanism of action of gentamicin?
A
- Aminoglycoside antibiotic that can pass through gram negative cell membrane in an oxygen dependent manner (so ineffective against anaerobic bacteria)
- Binds to the bacterial 30s ribosomal subunit disturbing the translation of mRNA leading to the formation of dysfunctional proteins
6
Q
What are some side effects of statins?
A
- Muscle toxicity can occur w/ all statins but risk increases w/ higher doses
- Constipation or diarrhoea and other GI symptoms
7
Q
What are some side effects of aspirin?
A
- Dyspepsia
- Haemorrhage in the elderly, coadminister PPI if past history of peptic ulcer as blockade of COX1 in gastric mucosal cells by aspirin reduces mucus/bicarbonate production which can expose the stomach lining to acid
8
Q
What are some side effects of trimethoprim?
A
- Diarrhoea
- Skin reactions
9
Q
What are some side effects of gentamicin?
A
- Ototoxicity
- Nephrotoxicity
