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Body Systems > Pharmacology of the Kidney > Flashcards

Pharmacology of the Kidney Flashcards

1
Q

what does aldosterone stimulate

A

sodium uptake

potassium excretion

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2
Q

where does renin come from and what does it do

A

from the kidney and stimulates angiotensiogen release from the kidney

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3
Q

where is angiotensin 1 converted to angiotensin 2

A

by ACE in the lungs

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4
Q

what does AG2 do

A

stimulate aldosterone and vasoconstriction

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5
Q

what type of drugs block renin release from the kidneys

A

beta blockers

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6
Q

what stimulates the kidney to release renin

A

pressure changes in afferent arteriole
sympathetic tone
macula densa chloride or osmotic concentration changes
local prostaglandin and NO release

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7
Q

what is the role of ACEi and where does it cat

A

inhibits vasoconstriction effect of AG2
acts on efferent arteriole
modulates intraglomerular pressure
increases sodium and water excretion

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8
Q

what are the indications of ACEi

A

hypertension
cardiac failure
CKD - reduces the intra renal pressure

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9
Q

what are the side effects of ACEi

A

hypotension - risk of AKI

hyperkalaemia - inhibits action of aldosterone

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10
Q

give two examples of ACEi

A

ramipril

lisinopril

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11
Q

what is the role of ARBs and what does it act on

A

inhibits vasoconstriction effect of AG2 on the receptor
acts on efferent arteriole
modulates intraglomerular oressure increases sodium and water excretion

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12
Q

what are the indications fo ARBs

A

hypertension
cardiac failure
CKD

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13
Q

what are the side effects of ARBs

A

hypotension

hyperkalaemia - inhibits action of aldosterone

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14
Q

what are two examples of ARBs

A

valsartan

irbesartan

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15
Q

where do osmotic diuretics work and what is an example

A

mannitol on the bowman capsule - modifies what is filtered

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16
Q

what is acetazolamide and where would it work

A

carbonic anhydrase inhibitor which works on both DCT and PCT to cause more Na+ excretion and water excretion

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17
Q

what is spironolactone and what does it do

A

inhibits aldosterone which stops Na reabsorption in the DCT

18
Q

where do thiazides work

A

on the DCT to stops sodium reabsorption

19
Q

give two examples of loop diuretics

A

furosemide

bumetanide

20
Q

what does amiloride do

A

stops Na absorption in the DCT

21
Q

what is the action of loop diuretics and when would you use them

A

inhibits uptake of water sodium potassium and chloride

CKD
nephrotic syndrome
hypertension
cardiac failure

22
Q

what are the side effects of loop diuretics

A

hypovolaemia

hypokalaemia

23
Q

when would you use thiazides

A

CKD
nephrotic syndrome
hypertension
cardiac failure

24
Q

what conditions would you use sprionlactone

A

cardiac failure or liver cirrhosis - ascites

25
Q

what are the side effects of sprionolactone

A

hyperkalamiea

26
Q

when would you use amiloride and what are the side effects

A

to prevent hypokalaemia

but can cause hyperkalaemia

27
Q

give an example of Vit D analogue and what it does

A

alpha calcidol which is hydrolxyted by the liver to active from - increases calcium uptake from the gut and phosphate

28
Q

what are the side effects of VIT D analogues

A

hypercalcaemia

hyperphosphateaemia

29
Q

what is EPO released from

A

produced buy cells in the interstitium of the kidney

30
Q

when is EPO required

A

when eGFR is lower than 15

31
Q

what are the side effects of EPO

A

hypertension

pure red cell aplasia

32
Q

when should you be careful about administering drugs to patients

A

with CKD or at risk of AKI

33
Q

when do prostaglandins to in the nephron

A

vasodilator afferent arteriole

34
Q

how can you stop prostoglandins affect on the nephron

A

use NSAIDS to inhibit PG release - ibuprofen, naproxen

35
Q

how do ARBs and ACEi affect the kidney

A

inhibit efferent arteriole vasoconstriction
decreases transglomerular pressure
decreases GFR

36
Q

which penicillin is not excreted by the kidney

A

flucloxacillin

37
Q

which opiates have the least amount of removal from the kidney

A

fentanyl
oxycodone
hydromorphone

38
Q

what is the danger of accumulation of active metabolites of opioids

A

increased incidence of CNS side effects and reparatory depression

39
Q

what can an accumulation of digoxin lead to

A

bradycardia
visual disturbances
mental confusion
hyperkalaemia

40
Q

what can accumulation of metaformin lead to

A

lactic acidosis

hypoglycaemia

41
Q

when should metaformin be avoided

A

when GFR is less than 30 ml / min

42
Q

what are cats claws and what can they induce

A

anti-inflammatory properties

causes AKI and hypotension

Body Systems (77 decks)

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