Pharm of Nephrotoxic Drugs

Question 1

Describe *DRUGS that induces Pre-renal Acute Kidney Injury

Answer 1

FARM NHC
1. Furosemide
2. Acetazolamide
3. RAAS Inhibitors(ACE-I and ARBs)
4. Mannitol
5. NSAIDS
6. Hydrochlorothiazide
7. Cyclosporine

Question 2

Describe the pharmacological causes of Post-Renal AKI

In post-renal, collecting duct is blocked

Answer 2

Drugs that cause cellular toxicity and breakdown of cellular debris which plugs collecting duct include:
1. Sulphonamides,
2. Ciprofloxacin
3. Aminoglycosides(Gentamycin, Amikacin)

Question 3

Acute Tubular Necrosis

Describe Pharmacological causes of Acute Tubular Necrosis

Answer 3

1. Aminoglycosides(Gentamycin and Amikacin)
2. Amphotericin B
3. NSAIDS
4. ACE-I and ARBs
   5.

Question 4

Describe the Contraindications and Indications Captopril

Answer 4

Indications
1. Reduces Hypertension
2. Used in Heart Failure
3. Reduce preload and afterload
4. Protective in Albuminuria, Proteinuria and Type 2 diabetes

Contraindications
1. RENAL STENOSIS(Unilateral or Bilateral)

It prevents drop in perfusion by causing vasodilation of efferent arteriole

Question 5

Describe the Indications and Contraindication of Enalapril.

Answer 5

Indications
1. Reduces Hypertension
2. Used in Heart Failure
3. Reduce preload and afterload
4. Protective in Albuminuria, Proteinuria and Type 2 diabetes

Contraindications
1. RENAL STENOSIS(Unilateral or Bilateral)

It prevents drop in perfusion by causing vasodilation of efferent arteriole

Question 6

Describe the Indications and Contraindications of losartan.

Answer 6

Indications
1. Reduces Hypertension
2. Used in Heart Failure
3. Reduce preload and afterload
4. Protective in Albuminuria, Proteinuria and Type 2 diabetes

Contraindications
1. RENAL STENOSIS(Unilateral or Bilateral)

It prevents drop in perfusion by causing vasodilation of efferent arteriole

Question 7

Describe how safe NSAIDS and COXIBS are in Renal Function

Answer 7

Safe in normal renal function

BUT

There’s a problem in compromised renal function.

NSAIDS decrease intraglomerular Autoregultion or Volume Depletion.

Question 8

Describe the use and adverse effect(specific to the renal system) of Cyclosporine

Answer 8

Uses-Immunosuppressant used in Organ(Kidney) transplant

A/E- Afferent Thrombus-casuses thrombus formation in the afferent arterioles which reduces perfusion of the kidney.

Question 9

Post-renal

Describe how you treat increase in back pressure in Post-renal disease

Answer 9

1. Atropine
2. Opiates
3. Amitriptyline
   4.Promethazine(Antihistamine)

Question 10

Describe MOA, Indications of Acetazolamide

Answer 10

MOA-Inhbits Carbonic Anhydraze and acts on proximal tubule

Indictions- Prevent dehydration of H2CO3 and Decrease HCO3 re-absorption

*Treat GLAUCOMA

Increases excretion of Sodium and Bicarbonate in the collecting duct

The topical Version of Acetazolamide=Dorzalamide

Causes Metabolic Acidosis

Question 11

Describe Indications of Diuretics (HCTZ, Furosemide, Spirinilactone)

Answer 11

Indications
1. Oedema
2. Congestive Heart Failure
3. Renal Disease
4. Glaucoma(group of eye disease)
5. Hepatic Cirrhosis
6. Hypertension
Raised Intracranial Pressure

Question 12

Describe the Indications of Mannitol

Answer 12

Not absorbed orally
Given IV

Prevents Water Resoprtion, dwars water out of cells, increases Urine Output

Indications
1. Decrease Intracranial Pressure
2. Decrease in Intraocular Pressure(Glaucoma)

Caution in Congestive Heart Failure.