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DNURS 836 Advanced Pharmacology for Anesthesia II > Nephro Meds & Medication Use Concepts - Final Wrap Up > Flashcards

Nephro Meds & Medication Use Concepts - Final Wrap Up Flashcards

1
Q

What happens in the Glomerulus w/ the Bowman’s Capsule?

A

Filtration

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2
Q

What occurs in the Proximal Tubule?

A

Reabsorption: Na, K, Glucose, Amino Acid, Bicarb, Protein

Secretion: H+, Foreign Substances, Anions & Cations

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3
Q

Where do Carbonoic Anhydrase Inhibitors & Osmotic Diuretics work?

A

Proximal Tubule

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4
Q

What does the Loop of Henle do?

A

Concentrates Urine

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5
Q

What occurs in the Descending Loop of Henle?

A

Water Reabsorption

&

Na diffuses In

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6
Q

What occurs in the Ascending Loop of Henle?

A

Active Na Reabsorption

&

Water Stays In

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7
Q

What happens in the Distal Tubule?

A

ADH mediated Water & Sodium Reabsorption

Bicarb Reabsorption

&

Secretion of K+, Urea, NH3+

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8
Q

Where in the Kidney do Thiazides work?

A

Distal Tubule

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9
Q

What occurs in the Collecting Duct?

A

ADH-mediated Water & Na Reabsorption

&

Final Concentration

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10
Q

How is Chronic Kidney Disease defined?

A

> 3 Months of Damage or GFC < 60

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11
Q

What is Stage 1 CKD?

A

Damage w/ GFR > 90

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12
Q

What is Stage 2 CKD?

A

Damage w/ GFR: 60-89

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13
Q

What is Stage 3 CKD?

A

GFR: 30 - 59

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14
Q

What is Stage 4 CKD?

A

GFR: 15-29

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15
Q

How is Kidney Failure defined?

A

GFR < 15

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16
Q

Which meds are Carbonic Anhydrase Inhibitors?

A

Acetazolamide

Methazolamide

Dichlorophenamine

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17
Q

How do Carbonic Anhydrase Inhibitors work?

A

Inhibits Calcium & H+ Secretion in the PCT

&

Blocks Bicarb & Na Reabsorption

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18
Q

What are some considerations when giving Carbonic Anhydrase Inhibtors?

A

Bicarb Loss

HYPOK Metabolic Acidosis

Tolerance

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19
Q

What are the side effects of Carbonic Anhydrase Inhibitors?

A

Vision & Taste Changes

GI effects

20
Q

Which meds are Osmotic Diuretics?

A

Mannitol

&

Urea

21
Q

How do Osmotic Diuretics works?

A

Big solute that pulls water in and increases Osmotic Gradient in the PCT

22
Q

What are the concerns when using Osmotic Diuretics?

A

↓Intracellular Volume

&

Hypernatremia

23
Q

How does Mannitol affect Urinary pH?

A

No Effect on Urinary pH

24
Q

Mannitol pulls fluid from intracellular space to expand ________, and redistributes it into the kidneys for elimination

A

Mannitol pulls fluid from intracellular space to expand intraVASCULAR, and redistributes it into the kidneys for elimination

25
Q

When is Mannitol used?

A

Renal Failure Prophylaxis

Increased ICP or IOP

Oliguria

26
Q

What needs to be intact in order for Mannitol to be effectivne in decreasing ICP?

A

Blood Brain Barrier must be intact

27
Q

What are the side effects of Mannitol?

A

Pulmonary Edema

Hypovolemia

Electrolyte Problems

28
Q

Why has Urea fallen out of favor?

A

Venous Thombosis

Tissue Necrosis

↑BUN

29
Q

Which meds are Loop Diuretics?

A

Furosemide

Bumetanide

Torsemide

Ethacrynic Acid

30
Q

How do Loop Diuretics work?

A

Stop Sodium & Chloride Reabsoption in the Ascending Loop & PCT

31
Q

Along with Sodium and Chloride, what other electrolytes are lost with Loop Diuretics?

A

Calcium

&

Magnesium

32
Q

What is the Renovascular Effect caused by Loop Diuretics?

A

Renal Vasodilation, ↑RBF, & Hypotension d/t Prostaglandins

33
Q

What is the Braking Phenomenon?

A

Acute Tolerance to Loop Diuretics

34
Q

Besides electrolyte imbalances, Loop Diuretics can also cause ______ & ______

A

Besides electrolyte imbalances, Loop Diuretics can also cause DEAFNESS & CROSS SENSITIVITY TO SULFA DRUGS

35
Q

What can happen when Loop Diuretics are given with Antibiotics?

A

Nephrotoxicity

36
Q

Which meds are Thiazide Diuretics?

A

-thiazide

Indapamide

Metolazone

Chlorthalidone

37
Q

How do Thiazides work?

A

Competes for Na-Cl Cotransporter int he DCT to stop Reabsorption

38
Q

What electrolyte imbalances can Thiazides cause?

A

HYPOK

&

HYPERcalcemia

39
Q

What are the side effects of Thiazides?

A

Hyperglycemia

Hyperuricemia

↓Renal & Liver Fxn

40
Q

Which meds are Potassium Sparing Diuretics?

A

Amiloride

Triamterene

Spironolactone

Eplerenone

41
Q

How do Amiloride & Triamterene work?

A

Stops Sodium Reabsorption from Aldosterone & Active Counterr Transport of Sodium & Potassium in the Collecting Duct

42
Q

How do Spirinolactone & Eplerenone work?

A

Competes for Aldosterone Receptors in the DCT

43
Q

When are K Sparing Diuretics used?

A

Refractory Edema from CHF & Cirrhosis d/t Increased levels of Aldosterone

44
Q

How do K Sparing Diuretics affect Urea & Glucose levels?

A

No Effect; Just HyperKalemia

45
Q

How is Acute Hyperkalemia treated?

A

Calcium Gluconate

Insulin

Albuterol

Lasix

Kayexalate

46
Q

What are other GI Potassium Binders besides Kayexalate?

A

Patiromer

&

Sodium Zirconium Cyclosilicate
(Better for Acute Therapy

47
Q

What do VAPTANS do?

A

ADH/Vasopressin V1 or V2 Receptor Blockers

DNURS 836 Advanced Pharmacology for Anesthesia II (12 decks)

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