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Pharmacy CPS Flashcards > KIDNEY > Flashcards

KIDNEY Flashcards

1
Q

common types of AKI

A

70% - hypo-perfusion of the kidneys

20% obstruction to urine flow

10% structural damaged due to ischemia, inflammation, toxins, necrosis

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2
Q

CKIDGO criteria for AKI

A

increased SCR >/ 26.5 mmol/L within 48 hrs or increased SCr >/1.5x baseline known/presumed to have occurred within prior 7days or
Urine volume < 0.5mL/kg/hr for 6 hrs

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3
Q

treatment for hyperkalemia

A

calcium gluconate, sodium bicarbonate, insulin, salbutamol, furosemide, sodium poystyrene sulfonate (exchanges sodium ions for potassium in intestinal cell) dialysis

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4
Q

know cockroft gault equation

A
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5
Q

CKIDGO definition of CKD

A

GFR <60 ml/min for>/3 months with or without signs of kidney damage
OR
presence of markers of kidney damage for >/3 months with or without decreased gfr

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6
Q

what factors doe KDIGO used to stage CKD

A

GFR and albuminuria

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7
Q

what stage is considered dialysis

A

G5

<15ml/min GFR

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8
Q

know staging of CKD

A 
G1: >/ 90 GFR 
G2: 60-90 
G3a and G3b: 30-59
G4: 15-29
G5: <15 or dialysis
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9
Q

which drug to use for albuminuria or proteinuria

A

ACEI or ARB

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10
Q

complications of CKD that we need to treat

A

anemia
hyperphosphatemia
secondary hyperparathyroidism ( HPT)

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11
Q

BP goal for CKD?

A

individualized.
<130/80 (BP)

<120 IF meets SPRINT criteria

SPRINT ( >50 years of age, elevated cardiovascular risk without diabetes

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12
Q

list the phosphate binder options

A

1st choice: calcium carbonate

2nd: lanthanum, sevelamer

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13
Q

which phosphate binder is preferred in stage 5 CKD

A

sevelamer

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14
Q

treatment for metabolic acidosis

A

sodium bicarb

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15
Q

important counselling points for calcium carb

A

Oral iron salts, fluoroquinolones, tetracyclines and levothyroxine: absorption reduced. Give 2 h before or 4 h after calcium.

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16
Q

unique side efffect of sevelamer

A

can lower LDL cholesterol by 30%

17
Q

too much vitamin D such as using alfacalcidol can caused what?

A

hypercalcemia and hyperphosphatemia

18
Q

where is Vitamin D metabolizes

A

kidney to become active Vitamin D ( calcitriol)

19
Q

how does PTH regulates phosphate

A

stimulating reabsorption of P from bone

Decreased reabosption of P from the kidneys

20
Q

what is the consequence of CKD on parathyroid hormone

A

INCREASE PO4, DECREASE CA sensing receptors( high results in higher serum calcium to suppress PTH) AND DECREASE ACTIVE VITAMIN D

21
Q

Treatment of HPT

A

normalize Ca2+
prevent increased in PO4 ( diet, phosphate binder, dialysis
correct vitamin D deficiency

22
Q

MOA of vitamin D analogues?

A

stimulate Ca absorption in the intestines
stimulates renal tubular Ca reabsorption
SUPPRESS PTH production

23
Q

what can oversuppression of PTH caused

A

decreased osteoblast and osteoclast activity
Ca uptake by bone is reduced
INCREASE risk of fractures and calcification

24
Q

indication for VITAMIN D analogues

A

to correct calcium level and manage hyperparthyroidism

25
Q

what does HPT do the the bones

A

high turnover bone disease
PTH stimulates osteoclasts and osteoblasts
increase resorption and bone formation
results in abnormal unmineralized osteoid

26
Q

MOA of cinacalcet

A

binds to Ca receptors to increase sensitivity to Ca and decrease PTH release

**not recommended as first line for HPT due to risk of hypocalcemia

27
Q

where erythroietin produce

A

kidney

28
Q

diagnosis of anemia

A

Hb < 130 in males

<120 in females

29
Q

what is the target HB when using ESA

A

<115 g/L

ePrex usually initiate when Hb 90-100 g/L

30
Q

what is the major concern with ESA

A

thromboembolism (with higher Hb targets)

hypertension
allergic reaction

31
Q

when should we initiate iron supplementatio n

A

ferritin <500 ng/mL AND Tsat <30%

32
Q

important counselling points of iron supplementation

A

take on empty stomach to increase absorption
take 1 hr before or 2-3 hrs after diary/ Ca supplements

warn about darkstools, constipatio, abdominial pian

33
Q

sick day management for insulin

A

hold bolus

continue basal

34
Q

Where in the nephron does active drug secretion most often occur?

A

proximal tubule

35
Q

What is the best method for initial testing of proteinuria in a patient with chronic kidney disease risk factors?

A

Urine albumin : creatinine ratio

Pharmacy CPS Flashcards (27 decks)

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