Pharmacotherapy of Acute and Chronic Kidney Disease Flashcards
Cation Exchange Resins:
Polystyrene Sulfonate
Use
- Hyperkalemia
Mechanisms of Action:
- Exchanges Na+ ions for K+ ions in the intestines →
↓excess K+
Desired effect
- Potassium levels back to normal range
Adverse effects
- Constipation, nausea, vomiting, hypocalcemia,
hypokalemia, hypomagnesemia, sodium retention
Loop
Diuretics:
Furosemide
Use
- Renal failure and hypertension
Mechanisms of Action
- Inhibits reabsorption of sodium and chloride in ascending loop of Henle
- Causes excretion of Na+, Ca2+, Mg2+, Cl-, water, and some K+
- ↑ excretion of potassium in the distal tubule of the kidney
Desired Effect
- Decreased BP, maintain urine output
Adverse Effects
- Headache, fluid & electrolyte imbalances (e.g.,
hypokalemia), orthostatic hypotension, hyperglycemia,
nausea and vomiting, diarrhea, polyuria
Erythropoiesis-
Stimulating Agents (ESA):
Epoetin Alfa
Uses:
RBC Formation Deficiency
Mechanism of Action
- interacts with receptors
on hematopoietic stem cells in bone marrow to
increase RBC production.
Desired Effect
- Reduced anemia with ↑RBCs
Adverse Effects
- Hypertension is the most common. Risk of
thromboembolic disease, TIA, stroke, MI, PE.
Vomiting, nausea, constipation, injection site
reaction.
Calcitriol
Class: Vitamin D analogues
Use
- Hypocalcemia in chronic renal disease,
hyperparathyroidism
Mechanism Of Action
- ↑ intestinal absorption, renal reabsorption of Ca++,
provides Ca++ for bones, increases renal tubular
resorption of phosphate
Adverse Effects
- Headache, weakness, palpitations, hypercalcemia,
nausea, vomiting, dry mouth, thirst, ↑ urination,
and muscle or bone pain
Calcium
Carbonate
Use: Calcium supplement, hyperphosphatemia
Mechanisms of action:
* normalizes phosphate level in CKD patients
Desired Effects
* Normal calcium and phosphate levels, neutralized
gastric acidity
Adverse Effects
* Constipation, anorexia, nausea, vomiting, diarrhea,
calculi, hypercalciuria, alkalosis
