meds Flashcards
when is EPO produced
hypoxia
main uses EPO
anaemia from CKD + cytotoxic therapy
SE EPO
hypertension –> encephalopathy + seizures // bone ache // flu symptoms // rash // red cell aplasia // thrombosis // iron deficiency
causes of failure to respond to EPO
iron deficiency // infection // hyperparathyroid // aluniminium toxicity
where do loop diuretics act
thick, ascending loop of Henle
mechanism Loop diuretics
block Na/K/Cl cotransporter // reduces absorption of NaCl
SE loops
hypo- ca, mg, K, Na // hypotension // hearing loss // gout
examples loops
Furosemide and bumetanide
where do thiazides act
early distal tubule
mechanism thiazides
Block Na/Cl –> increases Na concentration in urine
SE thiazides
hypo K, Na // HYPERCa // gout // impaired glucose tolerance // impotence // pancreatitis // agranulocytosis
examples thiazides
indapamide and chlortalidone, Bendroflumethiazide, (-thiazide) - used for mild HF
mechanism amiloride and triameterne
K sparing diuretics // block Na channels in distal tubule
mechanism spirinolactone (+ eplerone) + where do they work
aldosterone antagnost (block action) in collecting duct
indications K sparing diuretics
with other diuretics to prevent hypokalaemia
indications spirinolactone
ascites // resistant HTN // HF (NYHA III or IV) // nephrotic syndrome
SE spirnolactone
hyperkalaemia // gynaecomastia –> switch to elperonone
mechanism carbonic anhydrase inhibitors
increase excretion HCO3 (+Na, K, Cl)
indication Carbonic anhydrase inhibitors
glaucoma, prophylaxis altitude sickness
example Carbonic anhydrase inhibitors
Acetazolamide
mechansim Vaptans
act as competitive inhibitor ADH to prevent water reabsorption (encourage excretion)
mechanism SGLT2 inhiitors
inhibit SGLT2 transporter in proximal tubule –> excretion of glucose
SE SGLT2i’s
infection // lower limb amputation
benifits SGLT2i
weight loss, good for CVD
examples SGLT2i
Canagliflozin, dapagliflozin, empagliflozin
where are prostaglandings produced
medulla and glomeruli
action of PGE on kidney
low BP or arteriole vasocontriction –> cause vasodilation of afferent arteriole and release of renin
how can NSAIDs cause renal failur
inhibit COX –> reduce PGE production
what are type A drug reactions
augmented pharmacological effects in co-morbid patients –> adverse reaction eg prescribing diuretics in hypotension // dose dependent + predictable
what are type B drug reactions
dose independent + unpredictable // bizzare eg drug rashes, bone marrow aplasia
type C drug reactions
chronic eg steroid therapy –> cushings // BBlocker –> diabetes
type D drug reactions
delayed eg secondary cancer from radio // teratogenic
drug causes urinary retention
TC // antihistamines, anticholinergics // opioids // NSAIDs
mechanism finasteride
inhibitor of 5 alpha-reductase
indications finasteride
BPH, male pattern baldness
SE finasteride
impotence, low libido, ejaculation disorders, gynaecomastia + breast tenderness
finasteride effect on PSA
lowers it
indication Phosphodiesterase type V inhibitors
erectile dysfunction or pulm HTN
types of Phosphodiesterase type V inhibitors
sildenafil, tadalafil
contraindications Phosphodiesterase type V inhibitors
taking nitrites // hypotension // recent stroke or MI
SE Phosphodiesterase type V inhibitors
visual disturbance (BLUE vision), anterior ischaemic neuropathy // nasal congestion / flushing // GI, headache, prolonged erejction
drugs to avoid renal failure
tetracycline, nitrofurantoin, NSAIDs, lithium, metformin
drugs that accumulate in renal failure
abx, digoxin, methotrexate, SUR, furosemide, opioids
safe abx in renal failure
erythromycin + rifampicin
