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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
Q

Alpha -1 blockers

A

Prozasin, terazosin, doxazosin - decrease NE release and decrease SVR

26
Q

Uses of Alpha-1 blockers

A

3/4 line HTN, BPH

27
Q

Adverse effects of Alpha-1 blockers

A

orthostatic hypotension

28
Q

Clonidine

A

centrally acting Alpha2 AR agonists. To decrease PVR and HR. (decreases presynaptic Calcium)

29
Q

Adverse effects of clonidine

A

Ortho hypo, dry mouth, sedation

30
Q

Uses of Clonidine

A

3/4 HTN, ADHD, smoking cessation

31
Q

Methyldopa

A

Alpha2 AR agonist used to treat HTN in pregnancy. But rarely used due to hepatotoxicity, sedative, adverse side effects

32
Q

Sodium Nitroprusside

A

NO donor to activate ganyl Cyclase to cause smooth muscle relaxation.
Immediate onset.

33
Q

Uses of Mannitol

A

Intracranial Pressure, Glaucoma

34
Q

Acetazolamide

A

Used for Glaucoma, metabolic alkalosis, AMS

Side Effects: Metabolic acidosis

35
Q

Bumetanide

A

Loop diuretic

36
Q

Side Effects of Loop Diuretics

A

Gout, hypokalemia, hypocalcemia, hypomagnesium, metabolic alkalosis, ototoxicity

37
Q

Side Effects of Thiazide Diuretics

A

Decreased K and Mg, increase Uric acid and calcium. Hyperglycemia and lipids.

38
Q

Three agents after Transplant

A

1) Clacinerin Inhibitor
2) Proliferation Inhibitor
3) Prednisone

39
Q

Calcinerin Inhibitor Examples

A

Cyclosporin and Tacrolimus

40
Q

Mechanisms of Calcinerin Inhibitors

A

Inhibit dephosphorylation of NFAT to decrease IL-2

41
Q

MMF

A

proliferation inhibitor to decrease Purine synthesis

42
Q

mTOR inhibitors

A

Sirolimus - proliferation inhibitor to bind to FKBP

43
Q

CKD - Distribution of drugs

A

Increased or decreased Volume of distribution leads to toxicity

44
Q

What medicine must you dose for diabetes

A

Glyburide and Insulin

45
Q

HTN - what medicine must you dose?

A

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
Q

Treatment of Anemia in CKD

A

Epoetin and Darbepoetin

Recombinant DNA Erythropoetin analogs

47
Q

Calcium Acetate

A

used to tx osteodystrophy. a phosphate binding agent that binds to phosphate in GI to form insoluble form so it is fecally excreted.

48
Q

Calcimimetics

A

binds to calcium sensors on parathyroid gland to decreases parathyroid hormone secretion. Potent inhibitors of CYP2D6

49
Q

What drugs cause hyperkalemia

A

AA, ACEI, ARB, Digoxin

50
Q

Tx of chronic hyperkalemia

A

Sodium Polystyrene sulfonate to bind to K in intestine to decrease K absorption.

CVPR (12 decks)

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