Kidney Toxicity

Question 1

function of renal tubules is highly dependent on what

Answer 1

total epithelial cell integrity

Question 2

what happens when drugs compromise the total epithelial cell integrity

Answer 2

back-leaking of the renal filtrate and consequent diminished GFR

Question 3

what happens when cells become detached and aggregate in the tubule or adhere to epithelial cells downstream

Answer 3

tubular obstruction

Question 4

DRUGS that cause pre renal issues

Answer 4

Diuretics
ACE inhibitors
ARBs
antihypertensive agents

(Perhaps Ren) Died Acing ARBs Annie

Question 5

drugs that cause vasoconstriction

Answer 5

NSAIDs
radiocontrast
cyclosporine
tacrolimus
amphotericin B
VAL needs contrast to ambush

Question 6

drugs that cause Crystalluria

Answer 6

sulfonamides
methotrexate
acyclovir
triamterene
protease inhibitors

Crystal, Some might admire Tayshaun Prince

Question 7

drugs that cause tubular toxicity

Answer 7

aminoglycosides
cisplatin
vancomycin
pentamidine
radiocontrast

(A CLEAN VAGINA PROMOTES REPRODUCTION)

Question 8

drugs that cause endothelial injuries

Answer 8

cyclosporine
mitomycin C
tacrolimus
cocaine
conjugated estrogens
quinine
(CUT MY TALL COKE CON QUESO)

Question 9

drugs that cause glomerulopathy

Answer 9

penicillamine

NSAIDs

Question 10

drugs that cause interstitial nephritis

Answer 10

antibiotics
NSAIDs
diuretics

Question 11

high molecular weight proteins like albumin suggest what

Answer 11

glomerular damage

Question 12

low mol. wt. proteins like b2microglobulin suggest

Answer 12

proximal tubular damage

Question 13

long-term exposure to a number of drugs can produce maladaption of the damaged areas with development of what 3 things

Answer 13

glomerulosclerosis
tubular atrophy
interstitial fibrosis

Question 14

acetaminophen

Answer 14

proximal tubular necrosis: increase BUN and serum creatinine, decreased GFR

Question 15

NSAIDs inhibit what

Answer 15

prostaglandin synthesis

Question 16

NSAIDs have what effect on kidneys

Answer 16

vasoconstriction which leads to decreased renal bloodflow and ischemia

Question 17

chronic consumption of NSAIDs and tylenol can produce

Answer 17

analgesic nephropathy, characterized by interstitial nephritis and papillary necrosis

Question 18

aminoglycosides cause an increase in the number and size of what

Answer 18

lysosomes

Question 19

aminoglycosides cause drug-induced inhibition of what

Answer 19

sphingomyelinase and phospholipases, both important lysosome hydrolases

Question 20

rupture of the lysosomes causes what

Answer 20

exposing the contents of lysosome to cytoplasm, which is toxic

Question 21

amphotericin B impairs the functional integrity of …which leads to…..

Answer 21

glomerulus, proximal and distal tubules.

leads to decrease in RBF and decrease in GFR

Question 22

What effect does cyclosporine have on the kidneys

Answer 22

acute reversible renal dysfunction and acute vasculopathy

Question 23

how does cisplatin cause renal toxicity

Answer 23

through its MOA by inhition of DNA synth. and transport functions

Question 24

Pts treated with this drug permanently lose 10-30% of their renal function

Answer 24

cisplatin

Question 25

what drugs are considered the most nephrotoxic substance a pt might receive

Answer 25

radiocontrast agents

Question 26

what kinds of pts do you want to not give radio contrast

Answer 26

pts with pre-existing renal issues or other nephrotoxic drugs

Question 27

how do radiocontrast agents specifically cause nephrotoxicity

Answer 27

cause acute vasoconstriction and generation of ROS