L7: Pharmacology of the kidney Flashcards
ACEi act on the afferent or efferent arteriole?
efferent
How do ACEi work?
Block conversion of AT1 to AT2 and so inhibits the vasoconstrictive effects of AT2 causing vasodilation. They also remove sodium and water
Side effects of ACEi?
Hypotension
Hyperkalaemia
Which of the following are ACEi and which are ARBs? Ramipril Irbesartan Valsartan Lisinopril
Ramipril- ACEi
Lisinopril- ACEi
Valsartan- ARB
Irbesartan-ARB
What two things stimulate renin secretion?
Macula densa
Sympathetic tone
Loop diuretics inhibit the uptake of 4 molecules, what are these?
Sodium
Water
Chloride
Potassium
Side effects of loop diuretics are…
Hypovolaemia
Hypokalaemia
What is the function of thiazides?
Inhibits sodium uptake by removing sodium and water
Name a side effect of thiazides?
Hypovolaemia
How does spironolactone work?
Inhibits aldosterone prevents sodium reabsorption in exchange for potassium
Side effect of spironolactone?
Hyperkalaemia
How does Amiloride work?
Inhibits sodium reabsorption for potassium
Name a side effect of Amiloride.
Hyperkalaemia
WHat group of drugs are : furosemide, thiazide, amiloride?
Diuretics
How does a vitamin D analogue work?
Increase uptake of calcium (GOOD) and phosphate (BAD) from gut
What effect does CKD have on Ca levels?
Decrease activated vitamin D Decrease Ca Increase parathyroid hormone Secondary hyperparathyroidism Release Ca from bone Bone disease
What does erythropoietin do?
Stimulates the production of RBCs (erythropoiesis) which is normally stimulated under hypoxia
Define erythropoiesis
Production of red blood cells
WHy should non steroidal anti-inflammatory drugs be avoided in patients with CKS?
The inhibit prostaglandins which would normally have a vasodilatary effect on the afferent arteriole.
Why should ACE inhibitors be monitored so tightly in patients with CKD?
ACE inhibitors remove the vasoconstriction effects of the efferent arteriole. This consequently decreases the pressure and as a result the GFR.
Many doses of drugs should be altered in patients with CKD, why is this?
The kidneys normally remove various drugs from the blood stream, accumulation of drugs can often occur in patients with CKD.
Accumulation of digoxin can cause…
bradycardia, visual disturbances, mental confusion, hyperkalaemia
