Pharm Blessings Flashcards by Paige LaPointe

Are ya ready kids?

aye aye captain

How well did you know this?

Not at all

Perfectly

I can’t heaaarrrrr youuuuuuu

(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

How well did you know this?

Not at all

Perfectly

What electrolyte imbalance can HCTZ cause?

hypokalemia

How well did you know this?

Not at all

Perfectly

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

dysphagia

How well did you know this?

Not at all

Perfectly

What do you give to a person with hypokalemia?

KCl

How well did you know this?

Not at all

Perfectly

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

IV!

Because KCl tablets are the size of Necco wafers

How well did you know this?

Not at all

Perfectly

What do people with CKD most often die from?

CVD

How well did you know this?

Not at all

Perfectly

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

ace-i (kidney)

statin (heart)

How well did you know this?

Not at all

Perfectly

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

rhabidomylisisisisisisihatethisword

How well did you know this?

Not at all

Perfectly

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

amiloride [midamor]

spironolactone [aldactone]

(K-sparing)

How well did you know this?

Not at all

Perfectly

Which K-sparing diuretic should you avoid in men?

spironolactone [aldactone]

man b00bs

How well did you know this?

Not at all

Perfectly

SPIRONOLACTONE

[aldactone]:

what does this specific drug do for the heart?

prevents remodeleing and fibrosis

How well did you know this?

Not at all

Perfectly

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

hypercalcemia

(they go hand-in-hand)

(calcium and phosphate are lovers)

How well did you know this?

Not at all

Perfectly

What is the DOC for hyperphosphatemia?

SEVELAMER [Renagel]

How well did you know this?

Not at all

Perfectly

What is the MOA of Sevelamer [Renagel]?

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

How well did you know this?

Not at all

Perfectly

Which OTC drug contributes to HTN?

*drumroll*

Ibuprofen

How well did you know this?

Not at all

Perfectly

What do NSAIDS do to

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

a) retain it
b) inhibit them
c) vasoconstriction

How well did you know this?

Not at all

Perfectly

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

atenolol

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

acetaminophen

ibu can increase BP

How well did you know this?

Not at all

Perfectly

Can you use aspirin in a patient with gout?

(inc uric acid levels)

How well did you know this?

Not at all

Perfectly

How do you treat shingles?

How do you treat shingles in a pt with CKD?

Acyclovir

Less Acyclovir

How well did you know this?

Not at all

Perfectly

What can you rx to treat the pain of shingles?

lidocaine patches

How well did you know this?

Not at all

Perfectly

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

admit

IVF and electrolytes

How well did you know this?

Not at all

Perfectly

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

high

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

furosemide [lasix] due to ototoxicity

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

torsemide [demadex]

Which diuretic is just as effective PO or IV?

torsemide [demadex]

Where does furosemide [lasix] act in the kidney?

loop of henle

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

ethacrynic acid [edecrin]

what is the imaging of choice for renal artery stenosis?

duplex doppler ultrasound

Just pick one. a) kid stone b) kidney stone c) kidney rock d) kid rock

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

What do you rx for hyperparathyroidism? | (there are 4 drugs)

white - calcitriol [rocaltrol] blessington - cinacalcet [sensipar] sevelamer [renagel] CaCO3 [nephro-calci]

how do you restrict phosphate in your diet?

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

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

secondary parathyroid d/o

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

decreases **both** Ca and phospate levels decreases PTH

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

decreases phosphate but leaves Ca the same

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

metolazone [xaroxolyn] indapamide [lozol]

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

epo

What levels do you need to check before prescribing epo and why? (other than H/H)

serum Fe, B12, folate need to have adequate levels before rxing epo

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?

HCTZ is no longer working at such a low eGFR Switch to indapamide [lozol]

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

uric acid | (watch out for da gout monster)

Sasha/Blessington keeps saying this so if CC = peripheral edema what drug should you automatically think to give

metolazone [zaroxolyn]

Which thiazide diuretic do you use with a sulfa allergy?

trick question none

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

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

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?

C/I: NSAIDs and Colchicine Rx: oral prednisone

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

Switch to Clopidogrel [Plavix]

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

increases the risk for toxic epidermal necrosis

please list 3 drug categories that increase uric acid

thiazides asa loop diuretics

what are 2 major renal complications of gout?

nephrolithiasis chronic urate nephropathy

What level should Hgb be less than to prescribe epo?

Hgb \< 10

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?

it's from the dye give furosemide [lasix]

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

isotonic fluids

What does cyclosporin do to the vessels?

systemic and renal vasoconstriction

should you use NSAIDs in chf?

no - blocks dilation

"knock knock" "who's there" "kid" "kid who"

kid rock again he's lost get his autograph also [https://www.youtube.com/watch?v=0DQup4hd1\_o](https://www.youtube.com/watch?v=0DQup4hd1_o)

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

well either one would suck. but having 1 kidney fully functioning is better even though eGFR will be about the same

what electrolyte abnormality can spironolactone [aldactone] cause?

hyperkalemia

What's the big risk with hyperkalemia?

cardiac arrhythmias

What is an adjunct K sparing diuretic?

Triamterene [Dyrenium]

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

decreases heart fibrosis and remodeling

What is the big side effect of amlodipine?

peripheral edema!

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

CaCO3 [nephro-calci]

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

Calcitriol [rocaltrol]

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

sevelamer [renagel]

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

Vit D --\> active Vit D

What does active Vit D do?

helps facilitate absorption of Ca in the gut and bone reabsorption

What is CaCO3 typically used for?

lowering phosphate!

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

1500mg

what is the MOA of cinacalcet [sensipar]?

- nonhormonal regulator of mineral homeostasis - reduces PTH secretion and lowers phosphate

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

dialysis patients | (we really don't prescribe this drug)

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

"this too shall pass"

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

Mg! Probably low

What do you start if someone has hypomagnesemia?

MgCl [slomag]

What's the MOA of triamterene [dyrenium]

inhibits Na influx in DCT and CCT

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

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

yes and nobody really knows the context just pick it

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

cinacalcet

Which Ca-P drug is super expensive?

sevelamer [renagel]

when do you dose adjust allopurinol?

stage 4 and 5 CKD

What is another name for a kidney stone? a) nephrolithiasis b) renal calculi c) urolithiasis d) a kid rock

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

does metolazone lose its effectiveness below a GFR of 20?

Pharm Blessings Flashcards

(82 cards)