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CVPR > Drugs - Renal > Flashcards

Drugs - Renal Flashcards

1
Q

Uses of ACEI

A

HTN, Heart Failure, CKD, Diabetic nephorpathy

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2
Q

Side Effects of ACEI

A

Cough, Hyperkalemia, Increased Serum Creatinine, Angioedema

Contraindicated in pregnancy

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3
Q

Side Effects of ARBs

A

Same as ACEI: increased K, Cr, angioedema. No Cough

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4
Q

Lisinopril

A

ACEI

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5
Q

Amlodipine

A

CCB - DHP

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6
Q

Nifedipine

A

CCB - DHP

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7
Q

Diltiazem

A

CCB - NDHP

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8
Q

Verapamil

A

CCB - NDHP

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9
Q

DHP vs NDHP CCB

A

DHP are selective to peripheral calcium channel blockers and do not effect cardiac. (more potent vasodilation)
NDHP are non-selective and effect CO (decrease) - less potent vasodilators than DHP

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10
Q

DDI for DHP

A

Potent inhibition and metabolism by CYP450

Statins, amiodarone, cyclosporin, carbamazepine, grapefruit, macrolides

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11
Q

DDI for NDHP

A

mild inhibition of CYP450

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12
Q

Uses of CCB

A

DHP: HTN (second line for African American and Elderly), migraine prevention
NDHP: HTN, Agina, A fib, migraine prevention

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13
Q

Side Effects of CCB

A

DHP: Peripheral Edema, tachycardia, gingival hyperplasia
NDHP: Nausea, constipation, negative inotrope

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14
Q

Uses of Beta Blockers

A

HTN, PostMI, HF, Migraines

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15
Q

Side Effects of Beta Blockers

A

Sexual Dysfunction, bradycardia, bronchospasm, glucose and lipid dysregulation

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16
Q

Selective B-blockers

A

Atenolol and Metoprolol

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17
Q

Atenolol elimination

A

Renal

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18
Q

Metoprolol elimination

A

Liver

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19
Q

Propanolol

A

Nonselective Beta Blocker

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20
Q

Nonselective beta Blockeras

A

Propanolol and Timolol

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21
Q

Beta and Alpha Blockers

A

Carvedilol and Labetalol - good anti HTN

22
Q

Hydralazine

A

Vasodilator to increase cGMP and release NO.

23
Q

Minoxipil

A

Vasodilator to increase cGMP

24
Q

Side Effect of Vasodilators

A

Tachycardia, lupus Like, Hair growth, edema, neuropathy

25
Alpha -1 blockers
Prozasin, terazosin, doxazosin - decrease NE release and decrease SVR
26
Uses of Alpha-1 blockers
3/4 line HTN, BPH
27
Adverse effects of Alpha-1 blockers
orthostatic hypotension
28
Clonidine
centrally acting Alpha2 AR agonists. To decrease PVR and HR. (decreases presynaptic Calcium)
29
Adverse effects of clonidine
Ortho hypo, dry mouth, sedation
30
Uses of Clonidine
3/4 HTN, ADHD, smoking cessation
31
Methyldopa
Alpha2 AR agonist used to treat HTN in pregnancy. But rarely used due to hepatotoxicity, sedative, adverse side effects
32
Sodium Nitroprusside
NO donor to activate ganyl Cyclase to cause smooth muscle relaxation. Immediate onset.
33
Uses of Mannitol
Intracranial Pressure, Glaucoma
34
Acetazolamide
Used for Glaucoma, metabolic alkalosis, AMS | Side Effects: Metabolic acidosis
35
Bumetanide
Loop diuretic
36
Side Effects of Loop Diuretics
Gout, hypokalemia, hypocalcemia, hypomagnesium, metabolic alkalosis, ototoxicity
37
Side Effects of Thiazide Diuretics
Decreased K and Mg, increase Uric acid and calcium. Hyperglycemia and lipids.
38
Three agents after Transplant
1) Clacinerin Inhibitor 2) Proliferation Inhibitor 3) Prednisone
39
Calcinerin Inhibitor Examples
Cyclosporin and Tacrolimus
40
Mechanisms of Calcinerin Inhibitors
Inhibit dephosphorylation of NFAT to decrease IL-2
41
MMF
proliferation inhibitor to decrease Purine synthesis
42
mTOR inhibitors
Sirolimus - proliferation inhibitor to bind to FKBP
43
CKD - Distribution of drugs
Increased or decreased Volume of distribution leads to toxicity
44
What medicine must you dose for diabetes
Glyburide and Insulin
45
HTN - what medicine must you dose?
Diuretics - thiazides loose effectivity due to decreased delivery. Use loop ACEI/ARB: use throughout BB: only atenolol needs adjustment No adjustments for CCB, alpha blockers, vasodilators, clonidine
46
Treatment of Anemia in CKD
Epoetin and Darbepoetin | Recombinant DNA Erythropoetin analogs
47
Calcium Acetate
used to tx osteodystrophy. a phosphate binding agent that binds to phosphate in GI to form insoluble form so it is fecally excreted.
48
Calcimimetics
binds to calcium sensors on parathyroid gland to decreases parathyroid hormone secretion. Potent inhibitors of CYP2D6
49
What drugs cause hyperkalemia
AA, ACEI, ARB, Digoxin
50
Tx of chronic hyperkalemia
Sodium Polystyrene sulfonate to bind to K in intestine to decrease K absorption.

CVPR (12 decks)

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