Renal and Liver Disease Flashcards
What select drugs cause kidney disease?
What is the CrCl equation?
What key drugs are CI’d in CKD?
Aminoglycosides, Amophtericin B, Cisplatin, Cyclosporine, Loop diuretics, NSAIDs, Polymyxins, Contrast Dye, Tacrolimus, Vancomycin.
((140-age)/72 x SCr)) xweight X .85(females).
Nitrofurantoin, TDF products(stribild, complera, atripla, symfi), Voriconazole, TAF(genoya, descovy, etc), NSAIDS, Dabigatran, Rivaroxaban, SGLT2 inhibitors in GFR< 30, Metformin too.
Which drugs raise potassium levels?
What do you avoid when taking Harvoni(sofosbuvir/ledipasvir)?
Do DAA’s interact with inducers of CYP3A4 inhibitors?
ACE inhibitors, Aldosterone receptor antagonists, Aliskiren, ARB’s, Canaglifozin, Drosperinone- containing COC’s, Bactrim, Transplant drugs.
Acid suppressive therapy, Amiodarone due to serious bardy cardia when taken together.
YES (Carb, Oxcarb, phenobarbital, phenytoin, rifampin, rifabutin, st johns wort).
What birth control drug class do you stop when taking technivie and viekira?
Is it important to avoid Ribavirin in Pregnancy?
What’s the difference between interferon and peg interferon?
Ethyinyl estradiol contaning medicines.
YES!!!! This includes males, Can also cause hemolytic anemia.
Peg interferon has polyethelyne glycol added which prolongs the half life. Approved for treatment of HBV and HCV.
What is interferon’s BBW?
What are interferon’s side effects?
What are NRTI’s(LATTE) BBW?
Can cause or exacerbate neuropsychiatric, autoimmune, ischemic or infections disorders. If used with ribavarin watch for anemia and teratogenic stuff.
CNS effects, GI upset, Increase LFT’s, Myelosuppresion, Flu like syndrome(pre treat with acetaminophen and an antihistamine).
Lactic Acidosis, Severe hepatomegaly with steatosis, exacerbation of HBV upon discontinuation. If CrCl <50 mL/min, decrease dose/frequency except for vemlidy
What to watch for in TDF?
What to watch for in TAF?
Do you need to take Entacavir on an empty stomach?
Renal toxicity, Fanconi syndrome, osteomalacia, and decreased bone mineral density.
Dispense in original container.
Yes
Which key drugs have boxed warning for liver damage?
What drugs treat alcoholic liver disease?
How do you treat variceal bleeding?
Acetaminophen, Isoniazid, Ketoconazole(oral), Methotrexate, Nefazodone, NRTI’s, Propylthiouracil, Tipranavir, Valproic Acid.
Benzodiazepines in inpatient, Naltrexone, acamprosate, Disulfiram.
band ligation, sclerotherapy, Ocreotide(selective for splanchnic vessels, vasopressin is non selective). Non selective beta blockers added after resolution or for secondary prevention.
What non selective beta blockers are used in portal hypertension and what is their target heart rate?
What is 1st line therapy for acute and chronic hepatic encephalopathy? How does Lactulose work?
What are Lactulose’s Side effects?
Nadolol(Corgard), Propanolol(Inderal).55-60 BPM.
Lactulose followed by Rifaximin. Works by converting ammonia to intestinal bacteria by ammonium.
Flatulence, diarrhea, dyspepsia, abdominal dysfunction.
What is Neomycin’s BBW?
How do you treat ascites?
What is the ratio for furosemide and spironolactone?
Neurotoxicity(hearing loss, vertigo, ataxia).
restrict dietary sodium, spironolactone or combination of furosemide and spironolactone(furosemide alone is ineffective).
40 furosemide to 100 spironolactone to maintain potassium balance.
How do you treat Spontaneous bacterial peritonitis?
How do you counsel on Viekera PAK?
What is ribavirin’s primary adverse reaction?
Ceftriaxone(or equivalent)
Take 2 pink tablets and 1 beige tablet in the morning and the other beige tablet at night. Take with meals. Beige is dasabuvir. Helps treat HCV.
Hemolytic anemia. Typically develops within 1-2 weeks.
Is alfa or beta interferon used for liver disease?
Does Epivir treat HBV?
ALFA. Beta is used for MS.
NO! But Epivir HBV does.
