💊Pharmacology💊 - CKD Flashcards
What can CKD do to BP?
Cause hypertension
What effect does hypertension have on CKD?
Speeds up progression
What effect does having CKD have on the therapeutic objective of someone with hypertension?
Target BP becomes lower than what would otherwise be targeted
As a general rule, what is the approach to blood pressure in a patient with CKD?
TIGHT BP control
(slows CKD progression - regardless of underlying cause)
What can be given to a patient with Stage 2 hypertension who has CKD?
Amlodipine (L-type calcium channel blocker)
Atorvastatin as CVD risk >10%
Statins reduce cholesterol
What is the significance of proteinuria?
Marker of glomerular dysfunction
Damaging in its own right
What drugs/interventions improve proteinuria?
ACEi
ARBs
SGLT-2 inhibitors (e.g. dapagliflozin)
Salt restriction
What is key to note about using ACEi with amlodipine?
Amlodipine should be stopped if the addition of ACEi reduces blood pressure too much
When should aspirin be prescribed to someone with CKD and deemed at risk of CVD events?
Primary Prevention (no previous CVD events) → Generally avoid aspirin due to uncertain benefit and potential harm
Secondary Prevention (history of stroke, MI, or significant atherosclerosis) → Aspirin is justified as the benefits likely outweigh risks
What is the effect of trimethoprim on GFR calculations?
Trimethoprim inhibits the active secretion of creatinine
Trimethoprim breaks the link between creatinine and GFR
Explain the relationship between creatinine and GFR
What effect does ACEi have on GFR?
Reduces perfusion pressure in glomerulus - lower GFR
What effects does ibuprofen have?
Inhibits PG synthesis - reduces renal blood flow
Why does sepsis lower urine output?
Reduces perfusion pressure in glomerulus
What should be done to manage pain in a patient who also has CKD, and they are taking ibuprogen?
STOP ibuprofen
Start alternatives (e.g. paracetamol)
