Clinical Pharmacology of Renal Disease Flashcards
What occurs to drug concentration in renal disease?
Build up of active drug, toxic or active metabolites
What occurs if drugs have a high therapeutic index or a low toxicity during renal disease?
No issue
What occurs if there is a narrow therapeutic index?
Toxicity or death
In which endocrine disease is nephrotoxicity common?
Diabetes
How can diuretics induce renal failure?
Reduce fluid too much = dry patient out = kidney failure
How does renal impairment affect half life?
It prolongs half life meaning drugs/metabolites are in system for longer
What are the side effects of gentamicin?
Deafness, vestibular issues or nephrotoxicity
What does a reduction in GFR mean for drug metabolism?
Drug accumulation and reduced protein binding =
REDUCE the dosage, INCREASE the dose interval
How does renal disease alter the action of drugs on other tissues
Increases Blood-Brain Barrier permeability and makes brain more susceptible to opiates, tranquillisers and sedatives
Reduces Circulatory Volume = increased sensitivity to hypertensive drugs
Increased bleeding
Explain the link between hypertension, renal disease and antihypertensive drugs?
Hypertension can cause renal damage and vice versa
Those with renal impairment have a low GFR and hyperuricaemia which makes them MORE SENSITIVE TO HYPOTENSIVE ACTION OF ANTIHYPERTENSIVES
What are the side affects of ACEi?
Renal dysfunction
What are the side efffects of vasodilators?
Hypotension and salt/H2O retention
What are the effects of thiazides/TTD’s?
precipitation of gout
What form does renal damage take if the kidneys have been damaged by drugs?
Dehydration, oedema, Acute Tubular Necrosis, Acute Interstitial Nephritis, Chronic Renal Failure
What drugs causes pre-renal ARF?
Water and electrolyte disturbance - Diuretics, Laxatives, Lithium, NSAIDS
Increased Catabolism - steroids, tetracyclines
Vascular Occlusion - oestrogen
