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Paige: Renal Module! > Pharm Blessings > Flashcards

Pharm Blessings Flashcards

1
Q

Are ya ready kids?

A

aye aye captain

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2
Q

I can’t heaaarrrrr youuuuuuu

A

(that’s because it’s 11am on saturday and I have hardly even touched renal and I’m just a little bit burnt out by school in general but it’s okay)

oh….. AYE AYE CAPTAIN

some motivation to begin:

https://www.youtube.com/watch?v=1OrNS2zbTZg

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3
Q

What electrolyte imbalance can HCTZ cause?

A

hypokalemia

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4
Q

If a person isn’t getting enough K in their diet, what GI-related issue can that cause?

A

dysphagia

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5
Q

What do you give to a person with hypokalemia?

A

KCl

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6
Q

For someone with hypokalemia and dysphagia, which form of KCl supplementation is best and why?

A

IV!

Because KCl tablets are the size of Necco wafers

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7
Q

What do people with CKD most often die from?

A

CVD

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8
Q

in people with CKD, there are 2 protective drugs that we should put almost everyone on. what are they?

A

ace-i (kidney)

statin (heart)

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9
Q

A person on a statin with hypokalemia is at a greater risk for _____________.

A

rhabidomylisisisisisisihatethisword

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10
Q

In a person with hypokalemia, which diuretics would be best to use?

A

amiloride [midamor]

spironolactone [aldactone]

(K-sparing)

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11
Q

Which K-sparing diuretic should you avoid in men?

A

spironolactone [aldactone]

man b00bs

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12
Q

SPIRONOLACTONE

[aldactone]:

what does this specific drug do for the heart?

A

prevents remodeleing and fibrosis

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13
Q

When you are trying to treat hyperphosphatemia, what might you unintentionally give a patient?

A

hypercalcemia

(they go hand-in-hand)

(calcium and phosphate are lovers)

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14
Q

What is the DOC for hyperphosphatemia?

A

SEVELAMER [Renagel]

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15
Q

What is the MOA of Sevelamer [Renagel]?

A
  • nonhormal regular of mineral homeostasis -

^^^ lol good job paige

try #2: nonhormonal regulator of mineral homeostasis

binds phosphate in the GI tract to prevent absorption and promote excretion

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16
Q

Which OTC drug contributes to HTN?

A

*drumroll*

Ibuprofen

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17
Q

What do NSAIDS do to

a) Na and Water
b) prostaglandins
c) what is the overall effect

A

a) retain it
b) inhibit them
c) vasoconstriction

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18
Q

Which beta blocker (atenolol, metoprolol) is MORE excreted through the kidneys, and thus is WORSE in CKD?

A

atenolol

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19
Q

Does allopurinol need to be adjusted in a patient with CKD?

A

ya

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20
Q

In a pt with CKD and OA, would you prefer that they be on ibuprofen or acetaminophen and why?

A

acetaminophen

ibu can increase BP

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21
Q

Can you use aspirin in a patient with gout?

A

no

(inc uric acid levels)

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22
Q

How do you treat shingles?

How do you treat shingles in a pt with CKD?

A

Acyclovir

Less Acyclovir

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23
Q

What can you rx to treat the pain of shingles?

A

lidocaine patches

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24
Q

Unsure as to why all of these Maine men are out walking around in deserts, but regardless, how do you treat severe dehydration?

A

admit

IVF and electrolytes

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25
Q

If a person is severely dehydrated, will BUN/Cr be high or low?

A

high

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26
Q

Your patient has edema. What diuretic drug is C/I if she has hearing loss?

A

furosemide [lasix]

due to ototoxicity

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27
Q

What diuretic would you give to a pt with edema and hearing loss?

A

torsemide [demadex]

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28
Q

Which diuretic is just as effective PO or IV?

A

torsemide [demadex]

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29
Q

Where does furosemide [lasix] act in the kidney?

A

loop of henle

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30
Q

What diuretic do you give to a person with a sulfa allergy?

A

ethacrynic acid [edecrin]

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31
Q

what is the imaging of choice for renal artery stenosis?

A

duplex doppler ultrasound

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32
Q

Just pick one.

a) kid stone
b) kidney stone
c) kidney rock
d) kid rock

A

if you answered anything other than d then you’re not allowed to finish my flash cards.

also

https://www.youtube.com/watch?v=glb2U6y-GdU

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33
Q

What do you rx for hyperparathyroidism?

(there are 4 drugs)

A

white - calcitriol [rocaltrol]

blessington - cinacalcet [sensipar]

sevelamer [renagel]

CaCO3 [nephro-calci]

34
Q

how do you restrict phosphate in your diet?

A

avoid beans, nuts, seeds, cheese, and dark beverages

35
Q

What should you think about in a CKD patient when you see decreased Ca or increased phosphate?

A

secondary parathyroid d/o

36
Q

what does cinacalcet [sensipar] do to PTH, Ca, and phosphate levels?

A

decreases both Ca and phospate levels

decreases PTH

37
Q

what does selevamer [renagel] do to calcium and phosphate levels?

A

decreases phosphate but leaves Ca the same

38
Q

which thiazide diuretics don’t lose their effectiveness at an egfr of < 30-40ml/min

A

metolazone [xaroxolyn]

indapamide [lozol]

39
Q

What do you give to a pt who has anemia of chronic disease?

A

epo

40
Q

What levels do you need to check before prescribing epo and why?

(other than H/H)

A

serum Fe, B12, folate

need to have adequate levels before rxing epo

41
Q

Your patient has a BP of 150/100

He is taking HCTZ [microzide] for HTN

his eGFR is 25mL/min

What’s going on/what will you do?

A

HCTZ is no longer working at such a low eGFR

Switch to indapamide [lozol]

42
Q

What substance can indapamide [lozol] increase in the body?

A

uric acid

(watch out for da gout monster)

43
Q

Sasha/Blessington keeps saying this so

if CC = peripheral edema

what drug should you automatically think to give

A

metolazone [zaroxolyn]

44
Q

Which thiazide diuretic do you use with a sulfa allergy?

A

trick question

none

45
Q

Patient with HF comes into ER with hypovolemia and dehydration. He’s on a boatload of meds. What do you do?

A

hold all meds while you replace fluid volume

but it ends up being kind of a weird situation where you’re giving fluids but draining excess fluids at the same time

46
Q

Your patient has acute gout! (so many gout cases… please go back to MSK where you belong)

He also has CKD.

What drugs are C/I?

How will you treat?

A

C/I: NSAIDs and Colchicine

Rx: oral prednisone

47
Q

The dude with gout is taking ASA. Whatcha gonna do about that?

A

Switch to Clopidogrel [Plavix]

48
Q

Why can’t you put a CKD pt with gout on allopurinol?

A

increases the risk for toxic epidermal necrosis

49
Q

please list 3 drug categories that increase uric acid

A

thiazides

asa

loop diuretics

50
Q

what are 2 major renal complications of gout?

A

nephrolithiasis

chronic urate nephropathy

51
Q

What level should Hgb be less than to prescribe epo?

A

Hgb < 10

52
Q

someone gave a CKD patient (eGFR 35) a CT with contrast and now she has all this swelling in her legs. what’s going on? what do you do?

A

it’s from the dye

give furosemide [lasix]

53
Q

What else could you give to the CKD patient with contrast dye to better hydrate the kidneys during this?

A

isotonic fluids

54
Q

What does cyclosporin do to the vessels?

A

systemic and renal vasoconstriction

55
Q

should you use NSAIDs in chf?

A

no - blocks dilation

56
Q

“knock knock”

“who’s there”

“kid”

“kid who”

A

kid rock again

he’s lost

get his autograph

also

https://www.youtube.com/watch?v=0DQup4hd1_o

57
Q

Which is better, having 1 kidney working at 100% or having two kidneys working at 50%?

A

well either one would suck.

but having 1 kidney fully functioning is better

even though eGFR will be about the same

58
Q

what electrolyte abnormality can spironolactone [aldactone] cause?

A

hyperkalemia

59
Q

What’s the big risk with hyperkalemia?

A

cardiac arrhythmias

60
Q

What is an adjunct K sparing diuretic?

A

Triamterene [Dyrenium]

61
Q

What are the reasons that we would put someone with HF on spironolactone [aldactone]

A

decreases heart fibrosis and remodeling

62
Q

What is the big side effect of amlodipine?

A

peripheral edema!

63
Q

If your pt has decreased or normal serum Ca and high phosphate, which drug should you start with?

A

CaCO3 [nephro-calci]

64
Q

What if your pt has decreased serum Ca and you have no information about phosphate, then what’s the DOC?

A

Calcitriol [rocaltrol]

65
Q

What if you have elevated serum Ca and elevated serum phosphate? what’s the DOC?

A

sevelamer [renagel]

66
Q

as our kidneys don’t function as well, what conversion becomes harder for us?

A

Vit D –> active Vit D

67
Q

What does active Vit D do?

A

helps facilitate absorption of Ca in the gut and bone reabsorption

68
Q

What is CaCO3 typically used for?

A

lowering phosphate!

69
Q

When taking phosphate binding drugs, how much oral calcium can you take?

A

1500mg

70
Q

what is the MOA of cinacalcet [sensipar]?

A
  • nonhormonal regulator of mineral homeostasis -

reduces PTH secretion and lowers phosphate

71
Q

which patients do you usually give cinacalcet [sensipar] to?

A

dialysis patients

(we really don’t prescribe this drug)

72
Q

what motivational words should you tell your patients with kidney stones?

A

“this too shall pass”

73
Q

someone with low K is on a K supplement and isn’t responding. What levels should you check?

A

Mg! Probably low

74
Q

What do you start if someone has hypomagnesemia?

A

MgCl [slomag]

75
Q

What’s the MOA of triamterene [dyrenium]

A

inhibits Na influx in DCT and CCT

76
Q

Should you prescribe K supplements and K sparing diuretics at the same time?

A

No

77
Q

If Calcium Phosphorus Product test is one of the answers, should you pick?

A

yes and nobody really knows the context

just pick it

78
Q

Which Ca-P drug is only used in dialysis patients?

A

cinacalcet

79
Q

Which Ca-P drug is super expensive?

A

sevelamer [renagel]

80
Q

when do you dose adjust allopurinol?

A

stage 4 and 5 CKD

81
Q

What is another name for a kidney stone?

a) nephrolithiasis
b) renal calculi
c) urolithiasis
d) a kid rock

A

answer: d

obviously

here’s a reminder that you are cool (but not as cool as kid rock) as you finish the cards you rated 1-4:

https://www.youtube.com/watch?v=ax3H4vXXJNI

82
Q

does metolazone lose its effectiveness below a GFR of 20?

A

no

Paige: Renal Module! (4 decks)

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