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Critically Ill > Drug-Induced kidney disease > Flashcards

Drug-Induced kidney disease Flashcards

1
Q

What medications affect PGs and Ang II causing prerenal AKI?

A
  1. ACEi/ARBs
  2. NAIDs
  3. Cyclosporine
  4. Tacrolimus
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2
Q

How do NSAIDs cause low GFR?

A
  1. decrease in vasodilatory PGs
  2. Ang II compensated by increasing constriction and vascular resistance on efferent side
  3. low GFR both sides constrcited
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3
Q

How do ACEi/ARBs cause low GFR?

A
  1. decrease in Ang II on efferent side–> vasodilation
  2. increased PGs on the efferent side
    –> vasodilation
  3. low GFR both sides dilated
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4
Q

What is acute tubular necrosis? How does is lead to intrinsic AKI?

A
  1. direct damage to proximal and distal tubular cells from ischemic/toxic insult
  2. cells die and slough off leading to obstruction and increased intraluminal pressure, which reduces globular filtration
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5
Q

What medications can cause acute tubular necrosis?

A
  1. aminoglycosides
  2. radiographic contrast dyes
  3. cisplatin
  4. amphotericin
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6
Q

What drug class is most likely to cause acute allergic interstitial nephritis?

A

Diuretics

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7
Q

What is chronic interstitial nephritis?

A

progressive and irreversible lesion due to offending agents

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8
Q

What drugs cause chronic interstitial nephritis?

A
  1. Lithium
  2. Cyclosporine (long-term use)
  3. Tacrolimus (long-term use)
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9
Q

What drug class can cause papillary necrosis? How does this happen?

A
  1. Analgesics
  2. decreased blood supply with oxygen (nephropathy)
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10
Q

What drug is most likely to cause minimal change glomerular disease?

A

Lithium

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11
Q

What drugs are most likely to cause focal segmental glomerulosclerosis?

A
  1. heroin
  2. Lithium
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12
Q

What can cause membranous nephropathy?

A

Gold therapy

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13
Q

What medication is most likely to cause renal vasculitis?

A

Hydralazine (chronic use)

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14
Q

What medication is most likely to cause thrombotic microangiopathy?

A

oral contraceptives

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15
Q

What is most likely to cause cholesterol emboli (purple toe syndrome)?

A

warfarin

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16
Q

What are the mechanisms of post-renal or obstructive kidney disease?

A
  1. Crystal neuropathy
  2. nephrocalcinosis
  3. nephrolithiasis
17
Q

How is crystal nephropathy prevented?

18
Q

What medication is most likely to directly cause crystal neuropathy?

19
Q

What medication is likely to cause nephrocalcinosis?

A

oral phosphate sodium containing products
Fleet enemas

20
Q

What medication is used with amifostine to reduce the risks of nephrotoxicity?

21
Q

How long after receiving contrast dye should we wait before kidney function is evaluated and Metformin is resumed?

Critically Ill (20 decks)

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