Pharmacology and the kidney Flashcards
Where is the site of action of ACEi?
Efferent arteriole - inhibits vasoconstrictive effect of angiotensin II, sodium and water excretion
What are the indications for ACEi?
HTN, cardiac failure and CKD.
What are the side effects of ACEi?
Hypotension, hyperkalaemia
What is the site of action of Angiotensin receptor blockers?
Efferent arteriole, Na and water excretion and vasodilatation.
What are the indications for angiotensin receptor blockers?
Hypertension, cardiac failure, CKD
What are the side effects of ARBs?
Hypotension and hyperkalaemia.
What are the indications for loop diuretics?
Inhibits uptake of Na, K, Cl and water: CKD, nephrotic syndrome, HTN, cardiac failure and liver failure.
What are the side effects of loop diuretics?
Hypovolaemia and hyperkalaemia (can be used with k sparing diuretics)
What are the indications for thiazides?
Inhibits Na and water uptake: CKD, nephrotic syndrome, HTN and cardiac failure.
What are the side effects of thiazides?
Hypovolaemia
What are the indications for spironolactone/amiloride?
Prevents Na reabsorption in exchange for K: cardiac failure and liver cirrhosis
What are the side effects of spironolactone/amiloride?
Hyperkalaemia
How do vitamin D analogues work?
- Hydroxylated by liver to active form
- Increases uptake of: calcium from gut, phosphate from gut
- Side effects: hypercalcaemia, hyperphosphataemia
- Example - alpha calcidol
Where is erythropioetin produced?
By cells in the renal interstitium.
Which opioids have minimal renal excretion?
Fentanyl, oxycodone and hydromorphone
