Pharmacology of CKD Flashcards
What will happen to eGFR in a patient with kidney failure?
It will be low
What are some therapeutic objectives in those with kidney failure?
Lower BP to mitigate cardiovascular risk if they have high BP
Slow the progression of CKD
Increase their eGFR
Fix proteinuria
What antihypertensives are commonly used in CKD?
ACE inhibitor/angiotensin receptor blocker first line
Calcium channel blocker first line if they are black
What is the main target for treatment in CKD?
Blood pressure
What conservative management is advised in CKD to reduce cardiovascular risk?
Smoking cessation
Reducing salt intake
Exercise
When is atorvastatin prescribed?
When cardiovascular risk is over 10%
What drugs are used to combat proteinuria in kidney failure?
ACE inhibitor or angiotensin receptor blocker
SGLT-2 inhibitor
Stop amlodipine if BP becomes too low
When is aspirin prescribed?
If the patient has a very high risk of stroke or MI
Is it recommended to prescribe aspirin in CKD?
There is limited evidence of benefit and there is definitely a risk of harm
What are the risks associated with aspirin use?
It can increase the risk of stomach bleeding and the patient has to be careful if taking NSAIDs whilst on aspirin
How does trimethoprim effect GFR?
It inhibits the secretion from the blood into the tubules
Creatinine levels in the blood rise and this shows up on blood tests
This masks the GFR results and means GFR doesn’t reflect the deterioration of kidney function
How does ibuprofen effect GFR?
It prevents production of vasodilatory prostaglandins and this causes worsening GFR
What changes in drugs can be made if kidney function is deteriorating?
Pause ACE inhibitors or reduce their dose if pausing isn’t possible
Switch from NSAIDs to paracetamol
Stop nephrotoxic antibiotics if they’re on any
