Clinical Pharmacology in Renal Disease Flashcards
Nephrotoxic?
Drugs which can cause kidney damage
What is therapeutic index?
Quantitative measurement of the relative safety of a drug
Drugs are xenobiotics meaning the body recognises them as not being of self. How can the body deal with drugs?
-Body can prevent the drug from entering the bloodstream e.g. bloodbrain barrier
-Body can physically remove the drug
-Body can adapt drugs so that they can be removed from the body more quickly
In kinetics, what is the first mechanism for drugs by the body?
Absorption and distribution
What follows absorption and distribution?
Excretion and then metabolism
What is clearance?
Volume of plasma from which the drug would be totally removed per unit time
->babe even the lecturer said this was a weird definition
If someone had low clearance, what would this mean in terms of systemic exposure?
Higher systemic exposure
->and vice versa e.g. high clearance = lower systemic exposure
What is one risk of having low clearance?
Plasma concentration may be high enough to produce toxic effects
Does clearance ability increase or decrease with age?
Decrease
Clearance is a function of what three things happening at the kidney?
Glomerular filtration
Active tubule secretion
Tubular reabsorption
Which part of the kidney is especially important in filtration?
Glomerulus
Which two substances can be used to measure GFR as they undergo total renal clearance with no active secretion or reabsorption?
Creatinine and inulin
In which part of the kidney does active renal secretion occur?
Proximal tubule
What does reabsorption of a drug depend on?
Lipid solubility and concentration gradient in the tubule
If kidneys are not healthy, what happens to plasma concentration and half life?
Both increase
What is renal clearance proportional to?
GFR
->therefore, this means if we know a patient’s GFR, we can adjust the drug dose accordingly