KIDNEY drugs

Question 1

Loop diuretics: furosemide

Answer 1

Indication
-Renal failure, hypertension, edematous states, hepatic disease, ascites
Mechanisms of Action
-Inhibits reabsorption of sodium and chloride primarily on the ascending loop of Henle in the kidney
-Causes excretion of Na+, Ca2+, Mg2+, Cl-, water, and some K+
increase excretion of potassium in the distal tubule of the kidney
Desired effect
-Decreased BP, maintain urine output

Question 2

adverse effects of furosemide

Answer 2

Adverse effects
Headache, fluid & electrolyte imbalances (e.g., hyperkalemia), orthostatic hypotension, hyperglycemia, nausea and vomiting, diarrhea, polyuria

Question 3

Cation exchange resins: polystyrene sulfonate

Answer 3

Indication
-Hyperkalemia (in conjunction with other measures)
Mechanisms of Action:
-Exchanges Na+ ions for K+ ions in the intestines = decrease in excess K+
Desired effect
-Potassium levels back to normal range

Question 4

Cation exchange resins: polystyrene sulfonate- adverse effects

Answer 4

Adverse effects

-Constipation, nausea, vomiting, hypocalcemia, hypokalemia, hypomagnesemia, sodium retention

Question 5

Darbepoetin alfa

Answer 5

Classification: Erythropoiesis-Stimulating Agents (ESA)
Indication
-Anemia associated with chronic renal failure on and not on dialysis
Mechanisms of action
-Stimulates erythropoiesis by the same mechanism as endogenous erythropoietin; interacts with progenitor stem cells to increase red cell production
Desired effect
-Decreased anemia with increase RBCs

Question 6

Darbepoetin alfa -adverse effects

Answer 6

adverse effects
-Hypo/hypertension, cardiac arrest, thrombosis, dysrhythmias, chest pain, diarrhea, vomiting, nausea, abdominal pain, constipation, bone pain, dyspnea, pulmonary embolism

Question 7

calcitriol

Answer 7

Classification: Vitamin D analogues
Indication
-Hypocalcemia in chronic renal disease, hyperparathyroidism
Mechanism of action
-increase intestinal absorption, renal reabsorption of Ca++, provides Ca++ for bones, increases renal tubular resorption of phosphate
Desired effect
-Ca++ at normal level

Question 8

calcitriol adverse effects

Answer 8

Headache, weakness, palpitations, hypercalcemia, nausea, vomiting, dry mouth, thirst, increase urination, and muscle or bone pain

Question 9

Calcium Carbonate

Answer 9

Indication: Calcium supplement, hyperphosphatemia
Mechanisms of action:
-Acts like intrinsic calcium, normalizes phosphate level in CKD patients
Desired effects
-Normal calcium and phosphate levels, neutralized gastric acidity

Question 10

Calcium Carbonate

Answer 10

adverse effects

Constipation, anorexia, nausea, vomiting, diarrhea, calculi, hypercalciuria, alkalosis