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Renal > Glasgow Pharm > Flashcards

Glasgow Pharm Flashcards

1
Q

PGE2/PGI2 Renal

A

Increase renal blood flow
Decrease ADH induced water reabsorption
Decrease Chloride Reabsorption in Loop of Henle
Increase Renin Release

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2
Q

Adrenocorticosteroids that do not activate MR receptor

A

Triamcinolone
Betamethasone
Dexamethasone

Due to substitution on D ring.

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3
Q

Enzyme that takes Cortisol to Cortisone

A

11-Beta-Hydroxysteroid dehydrogenase 2

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4
Q

Synthetic Aldosterone like drug

A

Fludrocortisone

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5
Q

MR Receptor Antagonists

A

Spironolactone
eplerenone

Used for aldosterone excess, or cortisol excess.

S/E: hyperkalemia, metabolic acidosis, gynecomastia (esp Spiron), impotence (esp Spiron), and GI.

Spironolactone is a bit of an androgen receptor antagonist.

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6
Q

Fully activated form of Vitamin D

A

Calcitriol (1, 25-dihydroxy-cholecalciferol)

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7
Q

DHT—dihydrotachysterol

A

Vitamin D Synthetic derivative

no 1-OH needed for activation; does need liver 25-OH

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8
Q

1-alpha-hydroxycholecalciferol

Doxercalciferol (1-hydroxyvitamin D2)

A

already has 1-OH group

Does need liver 25-OH

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9
Q

Paricalcitol

A

Calcitriol Analog

reduces PTH without hypercalcemia
used in chronic renal failure

Analogs used when trying to shut down PTH after get calcium levels where they need to be.

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10
Q

22-oxacalcitriol

A

Calcitriol Analog

Suppressor of PTH gene expression, limited action on intestine and bone. Used in chronic renal failure, primary hyperparathyroidism. Low affinity for serum binding protein leads to shorter half life than calcitriol.

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11
Q

Sevelamer

A

Phosphate binding polymer

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12
Q

Cinacalcet

A

“calcimimetic.” Inhibits PTH secretion by enhancing the sensitivity of the CaSR (calcium receptor in the parathyroid gland). Lowers the concentration of Ca at which PTH secretion is suppressed.

Approved for treatment of secondary hyperparathyroidism due to chronic renal failure.

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13
Q

colchicine

A

Gout Drug used in Acute Attack when NSAIDs don’t work

interferes with mitotic spindle function
inhibits migration and phagocytic actions of granulocytes
inhibits neutrophil elaboration of inflammatory glycoprotein

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14
Q

NSAIDs used in Acute Gout Attack

A

naproxen, indomethacin, sulindac

These are your stronger NSAIDs

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15
Q

allopurinol

A

Used in chronic gout

parent drug and metabolite alloxanthine inhibit
xanthine oxidase, decrease uric acid synthesis

drug interaction: inhibits metabolism of azathioprine, 6-mercaptopurine

can be used with impaired renal function

Since it is a purine, it can interferer with metabolism of other purines like azothiaprine and 6-mercaptopurine which are cancer chemotherapy drugs; therefore back off dose x4

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16
Q

febuxostat

A

Used in Chronic Gout

nonpurine xanthine oxidase inhibitor

liver function abnormalities, diarrhea, nausea

Does have potential interaction

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17
Q

probenecid

A

Used in Chronic Gout

uricosuric agent, inhibits uric acid renal tubular reabsorption

developed to inhibit renal tubular secretion of penicillin

multiple drug interactions by blocking renal secretion

Need a functional kidney. Will not work in patients with kidney failure. Effects secretion of many organic ions, thus block elimination of other drugs, too.

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18
Q

rasburicase

A

Used in Chronic Gout

recombinant urate oxidase that oxidizes uric acid intomsoluble and inactive metabolite allantoin
used to manage plasma uric acid levels in pediatric patients receiving chemotherapy (for leukemia, lymphoma, etc.)
therapeutic efficacy may be limited by production of antibodies against drug

Oxidizes UA. Makes it more soluble

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19
Q

pegloticase

A

recombinant mammalian uricase coavalently attached to
methoxy plolethylene glycol (mPEG) to prolong
circulating half-life and diminish immunogenic response

treatment of refractory chronic gout

Same as rasburicase, but has pegalated group in order to extend half life

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20
Q

glucocorticoids

A

prednisone main player in immunosuppresive use of glucocorticoids. Stop cytokine production.

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21
Q

cyclosporine/tacrolimus

A

inhibits calcineurin phosphatase activity
decrease dephosphorylation of NFAT; therefore decreasing production of IL-2, 4, 6, etc
T-cell selective
renal toxicity due to accumulation in kidney. Tacrolimus not as much.
hyperglycemia with tacrolimus

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22
Q

sirolimus

A

same family as tacrolimus/cyclosporine
blocks T cell response to cytokines
inhibits a kinase involved in cell-cycle progression
hyperlipidemia as adverse effect

Binds to binding proteins, act on receptor (IL-2) and interfere with IL-2 signal transduction

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23
Q

everolimus

A

closely related to sirolimus; shorter half-life

quicker time to achieve steady-state concentration

24
Q

azathioprine/6-mercaptopurine

A

decrease purine biosynthesis
fraudulent nucleotide
allopurinol interaction

25
Q

mycophenolate mofetil

A

inhibits inosine monophosphate dehydrogenase
decrease de novo purine biosynthesis
T and B cell sensitive due to lack of salvage pathway
related drug: mizoribine

26
Q

methotrexate

A

inhibition of DHFR

27
Q

cyclophosphamide

A

alkylates DNA

effects on rapidly proliferating cells

28
Q

Antithymocyte globulin

A

Mixture of cytotoxic antibodies to various CD molecules

Adverse effects: fever, chills, hypotension

29
Q

Muromonab CD3

A

Antibody blocks binding of APC to T-cell
Blocks T-cell function
Decreases T-cell number
Initial stimulation of cytokine release syndrome

CD3 is an accessory protein that facilitates the interaction of APC with T Cell

Ultimately, begins synthesizing T cells that lack CD-3

30
Q

Daclizumab, Basiliximab

A

Monoclonal antibodies against IL-2 receptor
Blocks IL-2 mediated T-cell activation
Potential anaphylactic reactions

31
Q

Cholinergic

A

Muscarinic M3 receptor:
contracts detrusor muscle of bladder
relaxes trigone and sphincter

Agonism: pro voiding, pro emptying of bladder
Antagonist: decrease emptying

32
Q

Adrenergic

A 
Beta 2	relaxes bladder smooth muscle

alpha 1	contracts bladder base, urethral sphincter, prostate

Beta 1	increases renin release
33
Q

Cholinergic Activating Agents

A

Cholinergic activating agents - - bethanechol, neostigmine
stimulate bladder emptying
treatment of urinary retention problems post surgery
only used with no obstructive problems

e.g. use post surgery for flaccid bladder

34
Q

tolterodine, oxybutynin, darifenacin, solifenacin

A

Anti-Cholinergics:

relaxes bladder, slows voiding
treatment of bladder spasms post surgery or due to inflammation

treatment of urinary incontinence

35
Q

Alpha 1 agonists

A

ephedrine and pseudo ephedrine

for treatment of urinary incontinence

36
Q

Alpha 1 antagonists

A

prazosin, terazosin, doxazosin, tamsulosin

treatment of symptoms of urinary obstruction (BPH)

tamsulosin greater potency in inhibiting contraction in
prostate smooth muscle vs. vascular smooth muscle

Relax, help open up flow

37
Q

Acetazolamide

A

C.A. Inhibitor

38
Q

Methazolamide

A

C.A. Inhibitor

39
Q

Dichlorphenamide

A

C.A. Inhibitor

40
Q

Mannitol

A

Osmotic Agent

41
Q

Isorbide

A

Osmotic Agent

42
Q

Urea

A

Osmotic Agent

43
Q

Furosemide

A

Loop Diuretic

44
Q

Bumetanide

A

Loop Diuretic

45
Q

Ethacrynic Acid

A

Loop Diuretic

46
Q

Torsemide

A

Loop Diuretic

47
Q

Chlorothiazide

A

Thiazide

48
Q

hydrochlorothiazide

A

Thiazide

49
Q

Chlorthalidone

A

Thiazide

50
Q

Indapamide

A

Thiazide

51
Q

Metolazone

A

Thiazide

52
Q

Quinethazone

A

Thiazide

53
Q

Amiloride

A

Na channel K sparring

54
Q

Triamterene

A

Na channel K sparring

55
Q

Spironolactone

A

MR Antagonist K sparring

56
Q

Eplerenone

A

MR Antagonist K sparring

Renal (1 decks)

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