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CVPR: Renal (Exam 4) COPY > Pharmacology of Renal Failure > Flashcards

Pharmacology of Renal Failure Flashcards

1
Q

Name 4 drugs types that may cause hyperkalemia.

A
  • K+ sparing diuretics
  • ACE inhibitors
  • Angiotensin receptor blockers
  • Digoxin
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2
Q

____ is the most common cause of resistance to EPO therapy.

A

Iron deficiency

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3
Q

What is Cinacalet (Sensipar)?

A

a calcimimetic drug that directly reduces release of PTH

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4
Q

As kidney disease progresses, the serum concentration of EPO decreases and _____ results.

A

anemia

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5
Q

This drug is a vitamin D compound indirectly used to decrease PTH secretion.

A

calcitriol (Rocaltrol)

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6
Q

Although the majority of drug metabolism occurs in the liver, up to ____% of phase I CYP450 reactions occur in the kidney.

A

20

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7
Q

What is the definitive treatment for hyperkalemia?

A

hemodialysis

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8
Q

By the time pts reach stage 5 kidney disease, they are typically taking an average of ____ medications daily.

A

11

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9
Q

What is sodium polystyrene sulfonate (Kayexalate)?

A

a cation exchange resin that exchanges K+ for Na+ in the intestines- used to treat chronic, asymptomatic hypercalcemia

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10
Q

There are 5 stages of chronic kidney disease, from 1 to 5. In which stages are the doses of renally eliminated drugs adjusted?

A

3, 4, 5

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11
Q

Which drugs and physiologic mediators decrease dilation of the efferent arterioles, thereby decreasing GFR?

A
  • ACE-inhibitors
  • ARBs
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12
Q

Which drugs and physiologic mediators reduce dilation of the afferent arterioles, thereby increasing GFR?

A
  • NO
  • PGE2/PGE1
  • dopamine
  • caffeine (adenosine antagonist)
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13
Q

What is the tx for chronic, asymptomatic hyperkalemia?

A

sodium polystyrene sulfonate (Kayexalate)

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14
Q

This is a calcimimetic drug that directly reduces release of PTH.

A

Cinacalet (Sensipar)

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15
Q

Although the majority of drug metabolism occurs in the liver, up to 20% of _____ reactions occur in the kidney.

A

phase I CYP450

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16
Q

Which drugs and physiologic mediators increase constriction of the efferent arterioles, thereby increasing GFR?

A
  • Angiotensin II
  • NE
17
Q

This drug is a cation exchange resin that exchanges K+ for Na+ in the intestines- used to treat chronic, asymptomatic hypercalcemia.

A

sodium polystyrene sulfonate (Kayexalate)

18
Q

In diabetic pts without CKD, renal metabolism is responsible for the removal of ___% of an insulin dose.

A

30

19
Q

How can diuretic resistance from late stage CKD be overcome?

A

the use of synergistic combos of diuretics that act upon different sites in the nephron

20
Q

Name 5 temporizing therapies for acute hyperkalemia.

A
  1. IV calcium gluconate
  2. insulin
  3. glucose
  4. sodium bicarbonate
  5. beta-2 agonists (nebulized albuterol)
21
Q

What is calcitriol (Rocaltrol)?

A

a vitamin D compound indirectly used to decrease PTH secretion

22
Q

Which drugs and physiologic mediators increase constriction of the afferent arterioles, thereby decreasing GFR?

A
  • Angiotensin II
  • NE
  • adenosine
  • NSAIDs
23
Q

What are phosphate binding agents used for?

A

to decrease PO4- absorption and thereby decrease serum levels

24
Q

Which hyperlipidemia drugs need dose adjustments in stage 3+ CKD?

A

the fibrates (only use gemfibrozil in CKD stage 5)

25
Q

Dosing reductions are generally not recommended until GFR falls below _____ (stage 3 to stage 5).

A

50mL/min/1.73m3

26
Q

_____ are the recommended first line treatments for HTN.

A

Thiazide diuretics

27
Q

How does CKD affect phenytoin (Dilantin)?

A

Causes:

  • greater levels of free drug
  • greater ability to distribute outside of the plasma
  • greater potential for toxicity
28
Q

What are calcium acetate (PhosLo), sevelamer HCl (Renagel), and sevelamer bicarbonate (Renvela)?

A

phosphate binding agents

29
Q

What is stage 5 kidney disease?

A

kidney failure

30
Q

Which diabetes drugs need dose adjustments in stage 3+ CKD? Why?

A
  • glyburide (half life is prolonged)
  • metformin (NOT recommended if Scr>1.5)
  • insulin (half life prolonged)
31
Q

Which HTN drugs need dose adjustments in stage 3+ CKD and why?

A
  • thiazides (lose effectiveness with dz progression)
  • atenolol (half life prolonged)
  • ***DON’T USE K+ sparing diuretics in CKD
  • *** monitor K+ and Scr when using ACEs and ARBs
32
Q

What are Alfa (Epogen) and Darbepoeitin Alfa (Aranesp)?

A

pharmacological glycoproteins with biologic activity identical to EPO

33
Q

In pts with CKD, any given dose of Digoxin will result in a higher ____ due to a smaller Vd.

A

plasma concentration (Cp)

CVPR: Renal (Exam 4) COPY (29 decks)

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