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Renal Exam 2 > Pharmacology - Renal Stones > Flashcards

Pharmacology - Renal Stones Flashcards

1
Q

What are the four imbalances in the urine that can lead to calcium stone formation

A

Hypercalciuria (calcium)
Hyperoxaluria (oxalate)
Hyperuricosuria (uric acid)
Hypocitraturia (citric acid)

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2
Q

Identify the NSAID and narcotic analgesic of choice for the management of pain for renal colic

A

NSAID - ketorolac

Narcotic agent - morphine sulfate

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3
Q

What calcium channel blocker is given to aid in the passage of a kidney stone

A

Nifedipine

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4
Q

What is the mechanism of nifedipine

A

Suppress smooth muscle contraction and reduce ureteral spasm

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5
Q

What two alpha blockers are given to aid in the passage of a kidney stone

A

Tamsulosin

Terazosin

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6
Q

What is the mechanism of tamulosin and terazosin

A

Decrease ureteral smooth muscle tone and frequency and force of peristalsis

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7
Q

What is the treatment for hypercalciuria

A

Thiazide

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8
Q

What is the mechanism of thiazides

A

Inhibit Na/Cl transport –> increases Ca reabsorption

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9
Q

What are adverse effects of thiazides

A

Hypokalemic metabolic alkalosis
Hyperuricemia and gout
Hyperglycemia
Hyperlipidemia

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10
Q

How can you prevent hypokalemia with thiazides

A

Combine with amiloride

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11
Q

Why cant you combine thiazide with triamterene to prevent hypokalemia

A

Triamterene is highly insoluble in urine and may increase incidence of stone formation

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12
Q

How do you alkalize the urine

A

Potassium citrate

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13
Q

What kidney stones is allopurinol indicated for

A

Calcium stones

Uric acid stones

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14
Q

What is the mechanism of allopurinol

A

Inhibits xanthine oxidase the enzyme that synthesizes uric acid from hypoxanthine
Reduces uric acid formation

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15
Q

What type of stones is tiopronin and d-penicillamine used for

A

Cystine stones

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16
Q

What is the mechanism of tiopronin and d-penicillamine

A

Cystine is a dimer of cysteine linked by disulfide bridge

Tiopronin and penicillamine break the disulfide bridge and form a complex with cysteine

17
Q

What are the side effects of tiopronin and d-penicillamine

A

Gastrointestinal side effects
Dermatological complications
Hematologic abnormalities
Neurologic complications

18
Q

What are the hematologic abnormalities of tiopronin and d-penicillamine

A 
bleeding
anemia
leukopenia
thrombocytopenia
eosinophilia
19
Q

What is the neurologic complication of tiopronin and d-penicillamine

A

Myasthenic syndrome

Renal Exam 2 (5 decks)

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