k1dney t0x1c1ty Flashcards
how does aciclovir cause crystal-induced acute kidney injury?
low water solubility in less acidic conditions leads to crystal deposits in tubules, leading to inflammation and obstruction
how do sulphonamides cause crystal-induced acute kidney injury?
better soluble in basic conditions, acidic conditions leads to crystal desposits in tubules
how can NSAIDs cause haemodynamic nephrotoxicity?
inhibit prostaglandin synthesis
cause vasoconstriction and therefore reduce glomerular filtration rate, meaning less blood is filtered and more susceptible to toxicity
what statins are more likely to cause rhabdomyolysis? (ie are more lipophilic)
simvastatin
atorvastatin
cerivastatin (now off the market due to this risk)
what is rhabdomyolysis?
the rapid destruction of skeletal muscle
how do statins increase the risk of rhabdomyolysis?
when administered with other drugs that may inhibit glucuronidation or CYP4503A enzymes, increasing blood plasma conc
how does amphotericin b cause toxicity?
binding to cholesterol in membranes
increasing permeability of distal tubule
renal vasoconstriction reduces GFR in response to high ion content
how are immune complexes formed?
proteins reacting with
penicilamine
penicillins
sulphonamides
to form antigens
how do these immune complexes work?
by triggering antibody response (Bcells) that complex with antigen and deposit in glomerulus, causing inflammation and damage to the vasculature
how does gentamycin cause nephrotoxicity?
when ionised, they bond to the phospholipids of membranes in glomerulus, disrupt protein formation and sorting in mitochondria and ER
