Renal

Question 1

Name a carbonic anhydrase inhibitor and MOA

Answer 1

Acetazolamide

Inhibits carbonic anhydrase in PCT

Question 2

Use of carbonic anhydrase inhibitor

Answer 2

Glaucoma

Question 3

SE of carbonic anhydrase inhibitor

Answer 3

Drowsiness, renal stones, metabolic acidosis

Question 4

Name 2 loop diuretics and MOA

Answer 4

Furosemide, bumetanide
InhibitS Na/K/2Cl symporter in thick ascending limb
Massive NaCl excretion, Ca and K excretion

Question 5

Use and SE of loop diuretics

Answer 5

Oedema – CCF, nephrotic syndrome,
hypercalcaemia
SE: hypokalaemic met alkalosis, ototoxic, hypovolaemia

Question 6

Name 2 thiazides and MOA and SE

Answer 6

Bendroflumethiazide
Indapamide
Inhibits NaCl co-transporter in DCT
Can cause gout

Question 7

SE methotrexate?

Answer 7

Can cause renal tubular acidosis
Also renally excreted so can build up in renal failure
-> neutropenia/pancytopenia

Question 8

How long does it take for a drug to reach steady state plasma concentration?

Answer 8

5 x half life

Question 9

Do you always reduce doses in renal impairment?

Answer 9

Not if loading dose is required for an immediate action

Give loading dose then reduce the maintenance doses

Question 10

When should creatinine clearance be used with caution?

Answer 10

Dependent on muscle mass and diet

CrCl caution: vegans, elderly, body builders, amputees, muscle wasting disorders

Question 11

Where do you find the eGFR and CrCl equations?

Answer 11

Prescribing in renal impairment

Halfway down the page

Question 12

When should eGFR not be used?

Answer 12

BMI above 40 or below 18

Question 13

How is CKD staged?

Answer 13

GFR vs ACR

Increased risk with both GRF reduction and ACR increase