drugs affecting the kidneys W2 Flashcards

1
Q

actions of loop diuretics?

A

decrease Na+/K+/2CL- in thick ascending limb

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2
Q

indications of loop diuretics?

A

heart & renal failure
liver cirrhosis with ascites

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3
Q

adverse effects of loop diuretics?

A

hyponatraemia, hypokalaemia, metabolic alkalosis
fluid depletion (dehydration, hypovolaemia), incontinence
ototoxicity (hearing/balance probs)

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4
Q

actions of thiazide diuretics?

A

inhibit Na+/Cl- co-transport in distal convoluted tubule
vasodilation

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5
Q

indications of thiazide diuretics?

A

hypertension

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6
Q

adverse effects of thiazide diuretics?

A

hypokalaemia, hyponatraemia, hypomagnesaemia, alkalosis
hyperuricaemia, hyperglycaemia
fluid depletion, incontinence, erectile dysfunction

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7
Q

actions of potassium-sparing diuretics?

A

decrease aldosterone receptor mediated formation of the Na+/K+ exchanger in basolateral membrane of distal tubule
amiloride blocks Na+ channel in luminal membrane

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8
Q

indications of potassium-sparing diuretics?

A

chronic heart failure
liver failure with ascites
resistant hypertension
primary hyperaldosteronism (Conn’s syndrome)

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9
Q

adverse effects of potassium-sparing diuretics?

A

hyperkalaemia
spironolactone oestrogenic effects (gynaecomastia)

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10
Q

what is amiloride? what does it have the same action as?

A

sodium channel blocker (type of potassium-sparing diuretic)
has same action as aldosterone receptor antagonists (spironolactone)

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11
Q

actions of osmotic diuretics?

A

freely filtered but non-absorbed creating an osmotic ‘drag’ that decreases water and Na+ reabsorption in renal tubule

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12
Q

indications of osmotic diuretics?

A

raised ICP due to cerebral oedema
raised intra-ocular pressure

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13
Q

adverse effects of osmotic diuretics?

A

initial fluid overload, hypernatraemia

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14
Q

actions of carbonic anhydrase inhibitors?

A

inhibits carbonic anhydrase in proximal tubular cells
decreased H+ and bicarbonate available for exchange with Na+
mild natriuresis and alkalisation of urine

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15
Q

indications of carbonic anhydrase inhibitors?

A

glaucoma
altitude sickness

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16
Q

adverse effects of carbonic anhydrase inhibitors?

A

metabolic acidosis

17
Q

erythropoietin features

A

stimulates red cell formation in bone marrow
haemoglobin conc. should be maintained within 100-120g/L

18
Q

vitamin D features

A

requires hydroxylation in the kidney
patients can be given hydroxylated derivatives to prevent the development of renal osteodystrophy

19
Q

sodium bicarbonate features

A

corrects acidosis of renal failure

20
Q

SGLT-2 inhibitors features

A

inhibit at least 90% renal glucose reabsorption
indicated for type 2 diabetes

21
Q

uricosuric drugs features

A

inhibit uric acid re-absorption in proximal convoluted tubule
indicated for preventing gout

22
Q

3 categories of drugs with adverse effects on the kidneys?

A

drugs causing a reduction in extracellular volume
drugs with direct effects on renal vasculature
drugs with direct toxic effects

23
Q

what drugs (or drug symptoms) cause dehydration

A

diuretics
drug-induced diarrhoea
drug-induced vomiting

24
Q

what diuretics cause dehydration

A

loop diuretics
thiazide diuretics

25
what drugs cause drug induced diarrhoea (leading to dehydration)
laxatives proton pump inhibitors antibiotics
26
what causes drug induced vomiting (leading to dehydration)
chemotherapy
27
what drugs alter renal perfusion
drugs suppressing the RAS NSAIDs
28
what drugs suppress the renin-angiotensin system and how
ACE inhibitors ARAs (angiotensin receptor antagonists) block the formation of angiotensin II
29
how do NSAIDs alter renal perfusion
reduce cortical blood flow and glomerular perfusion by block production of vasodilating prostaglandins by cyclo-oxygenase
30
actions of ACE inhibitors?
inhibit angiotensin-converting enzyme decreased: ->angiotensin 2 ->vasopressin ->aldosterone ->BP ->Na+ retention ->K+ excretion
31
indications of ACE inhibitors?
hypertension chronic heart failure
32
pharmacokinetic effects of renal impairment
reduced plasma clearance increased drug half-life drug accumulation after repeated doses
33
drugs that impair renal function?
diuretics ACE inhibitors NSAIDs