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2 - CPR (renal) > Drugs for Hypo/Hypernatremia > Flashcards

Drugs for Hypo/Hypernatremia Flashcards

1
Q

“-volemia” refers to what measurement?

A

Na+ CONTENT

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2
Q

Edema refers to what measurement?

A

Na+ CONTENT

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3
Q

Na+ content is described how?

A

“-volemia”

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4
Q

“-natremia” refers to what measurement?

A

Na+ concentration which is determined by the WATER amount

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5
Q

What determines the Na+ concentration?

A

Water amount

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6
Q

Na+ content does not equal Na+ concentration. Where are each measured and what system effects them?

A

Na+ content - ECF; RAAS system

Na+ concentration - Plasma; ADH

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7
Q

This refers to the effect of a solution on the volume of the cell

A

Tonicity

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8
Q

What happens to the cell with a hypotonic solution?

A

Cell swells

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9
Q

What happens to the cell with a hypertonic solution?

A

Cell shrinks

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10
Q

0.9% NaCl is?

A

Isotonic saline

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11
Q

Effect of Isotonic Saline (nacl)?

A

Increased ECF volume

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12
Q

Effect of Hypotonic Saline (0.45% nacl)?

A

Both ECF and ICF increase

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13
Q

Effect of Hypertonic Saline (3-5% nacl)?

A

Increased ECF and decreased ICF

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14
Q

Effect of Albumin?

A

Plasma volume increases

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15
Q

Effect of 5% dextrose?

A

Increased total body water

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16
Q

The body fluid volume and concentration must remain relatively constant. What ensures that happens?

A

Water and solutes are excreted separately

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17
Q

Body Na+ content issues are reflected with hypo/hypervolemic ECF. What are the signs of Hypovolemic ECF?

A
  • Decreased skin turgor, thirst and dry mucous membranes
  • Oliguria
  • Increased HR and decreased BP
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18
Q

Body Na+ content issues are reflected with hypo/hypervolemic ECF. What are the signs of Hypervolemic ECF?

A

Weight gain and edema

- Bounding pulses

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19
Q

What defines Hypernatremia?

A

Plasma [Na+] > 145

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20
Q

What defines Hyponatremia?

A

Plasma [Na+] < 135

21
Q

Hypernatremia and Hyponatremia mean that there is a ____ problem

A

Water problem

22
Q

What are the symptoms for Hyponatremia?

A

SALT LOSS

  • Stupor/coma
  • Anorexia (N/V)
  • Lethargy
  • Tendon reflexes decreased
  • Limp
  • Orthostatic hypotension
  • Seizures
  • Stomach cramp
23
Q

What are the symptoms for Hyponatremia?

A

SALT LOSS

  • Stupor/coma
  • Anorexia (N/V)
  • Lethargy
  • Tendon reflexes decreased
  • Limp
  • Orthostatic hypotension
  • Seizures
  • Stomach cramp
24
Q

This class of drugs causes more solute loss than water loss

A

Diuretics

25
Q

This class of drugs causes more water loss than solute loss

A

Vaptans

26
Q

To treat Hyponatremia, what is the treatment for no or minimal symptoms?

A

Fluid restriction

27
Q

To treat Hyponatremia with moderate symptoms, what is the treatment?

A

Vaptans or Hypertonic NaCl

28
Q

To treat Hyponatremia, what is the treatment for severe symptoms?

A

Hypertonic NaCl

29
Q

When treating severe Hyponatremia with Hypertonic NaCl, if it is infused/corrected too fast, what side effect can occur?

A

Osmotic demyelination syndrome

30
Q

Vaptans can treat Hyponatremia. What is their MOA?

A

(-) ADH-regulated water reabsorption to promote excretion of free water

31
Q

Where do Vaptans work?

A

Collecting duct

32
Q

What are the 2 Vaptans for Hyponatremia?

A

Conivaptan

Tolvaptan

33
Q

How is Conivaptan given and what receptor does it work at?

A

IV

– affinity to block both receptor types (V1A and V2)

34
Q

How is Tolvaptan given and what receptor does it work at?

A

Orally in the hospital setting

– Selective V2 receptor antagonist

35
Q

Why must Tolvaptan be used for LESS than 30 days?

A

Chronic use can cause hepatotoxicity

36
Q

Besides Hyponatremia, what else is Tolvaptan used for?

A

Slows the progression of adult polycystic kidney disease

37
Q

What are some possible side effects of the Vaptans?

A

Orthostatic hypotension
Fatigue and thirst
Polyuria/bedwetting

38
Q

What are the symptoms of Hypernatremia?

A

TRIP

  • Tremors/twitching
  • Restlessness
  • Intense thirst
  • Pulmonary and peripheral edema
39
Q

What are the symptoms of Hypernatremia?

A

TRIP

  • Twitching/tremors
  • Restlessness
  • Intense thirst
  • Pulmonary and peripheral edema
40
Q

If a patient has Hypernatremia and hypovolemia, what type of saline should be given?

A

Isotonic

41
Q

If a patient has Hypernatremia and they are NOT hypovolemic, what type of saline should be given?

A

Hypotonic

42
Q

What is a drug to treat Hypernatremia?

A

Desmopressin (DDAVP)

43
Q

What is a drug to treat Hypernatremia?

A

Desmopressin (DDAVP)

44
Q

MOA for Demopressin?

A

V2 agonist (ADH analog) which increases water reabsorption

45
Q

With what conditions is Desmopressin used?

A

Central diabetes insipidus

Primary nocturnal enuresis

46
Q

What is a possible adverse effect of Desmopressin?

A

Hyponatremia

47
Q

What is a possible adverse effect with Desmopressin?

A

Hyponatremia

48
Q

Desmopressin can treat Hypernatremia. What is its MOA?

A

ADH analog that is a V2 agonist ==> increases water reabsorption

2 - CPR (renal) (27 decks)

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