E3: Renal

Question 1

What kind of drug interaction does Digoxin have with furosemide?

Answer 1

-Loop diuretics can cause hypokalemia and hypokalemia leads to increased risk of digoxin toxicity

Question 2

What is the drug interaction between Digoxin and Carvedilol?

Answer 2

Risk of bradycardia and AV block

Question 3

What are the drug interactions with Furosemide, Carvedilol, and lisinopril?

Answer 3

all can lower BP, increased risk of hypotension

Question 4

What is the presentation of Digoxin toxicity?

Answer 4

• Cardiac arrhythmias
• Anorexia, N/V, abdominal pain, diarrhea
• Confusion, weakness, lethargy, fatigue
• Visual disturbance

Question 5

What is the toxic level of Digoxin on serum studies?

Answer 5

> 2ng/ml

Question 6

How do ACE-I affect the GFR?

Answer 6

Vasodilators that effect the efferent arteriole

Question 7

How do NSAIDs affect the GFR?

Answer 7

Vasoconstriction of the afferent arteriole

Question 8

What are the equations that can help with renal dosing?

Answer 8

• CKD-EPI
• MDRD
• Cockcroft and Gault

Question 9

What are we worried about in a patient taking Metformin in the setting of kidney disease?

Answer 9

Lactic acidosis

Question 10

What does of CKD does Metformin use start to become concerning?

Answer 10

• 3A: avoid if kidney function is expected to become unstable
• Do not use in Stage 4 and 5

Question 11

What is the Beers criteria for Bactrim?

Answer 11

-Can elevate risk of hyperkalemia in patients with decreased kidney function who are receiving ACE-I or ARBs