renal disease

Question 1

BUN to SCR 20:1 meaning

Answer 1

dehydration AKI

Question 2

where does SGLT2 act in the glomerulus

Answer 2

In the proximal tubule 65% of NAgets reabsorbed here

Question 3

where does Thiazide diuretics work

Answer 3

in the distal convulated tubule

Question 4

where does K spairn diuretics work

Answer 4

collecting duct

Question 5

drugs that are nephrotoxic

Answer 5

aminoglycosides
amp B
Cisplatin
cyclosporine
loop diuretics
NSAIDS
polymyxins
dye
tacrolimus
vancomycin

Question 6

what does albumin it body represent in staging renal disease

Answer 6

albumin in urea >30 represents CKD
EGR <60 represents CKD

Question 7

1st line for HPT
HPT with DIbaetes

Answer 7

Ace or ARB in CKD with albuminuria
if baseline Scr jumps >30% DC the ace/arb

+diabetes
- ACE/ARB
- SGLT2

Question 8

what drugs require changes due to renal function

Answer 8

aminoglycosides, beta lactams, fluconazole, quinolones, vanc
LMWH, Rivoroxaban, apixaban, dabigatran
H2RAs, metoclopramide
bisphos, lithium

Question 9

Cr< 60 avoid

Answer 9

nitrofurantoin

Question 10

CrCL <50 avoid

Answer 10

tenofovir
voriconazole

Question 11

CrCL < 30 avoid

Answer 11

TAF
NSAIDS
dabigatran, rivoroxaban

Question 12

CRcL< 30 avoid

Answer 12

SGLT2
metformin

Question 13

what minerals disorders in people with CKD

Answer 13

hyperphosphatemia- elevated PTH and phosphorus (phosphate binders before meals)
vitamin D deficiency
Iron deficiency
hyperkalemia
metabolic acidosis

Question 14

what are some ways to prevent hyperphosphatemia

Answer 14

aluminum hydroxide (TID with meals
Calcium based- 1st line, acetate carbonate, TID with meals can cause hyper calcemia
aluminum free/ calcium free- $$$ ferric citrate, lanthanum carbonate, TID with meals
- Sevelamer carbonate- renvela TID with melas can also reduce ADEK also LDL 30%

Question 15

how does PTC and phosphate or CKD

Answer 15

1. kidney cant eliminate PHOS increases phos
2. vit D cannot be activated also decrease calcium abosorption
3. high phos low cal causes increase release of PTH
4. PTH causes calcium apsorbtion but in CKD its not possible so Ca is pulled from bones causing fractures
5. Low EPP levels cause anemia

Question 16

what is used to treat Vit D defeciency

Answer 16

D3 in skin
D2 is from diet
vit D as calcitrol increases calcium absorbtion
cinacalcet (sensipar) increases sensitivity of calcium receptors only used in dialysis patients

Question 17

what drugs stabalizes Potassium

Answer 17

stabalizes
- calcium gluconate

Question 18

what are some drugs that increase K levels

Answer 18

Ace aldosterone aliskiren ARBS
SGLT2
dropirone containing contraception
bactrim
transplant drugs

Question 19

what anticoags are contraindicated in hemodialysis

Answer 19

fondaparinux
dabigaatran
rivoraxaban

** heparin and waarfarin should be used

Question 20

what drugs remove K from body

Answer 20

• furosemide
• hemodylysis
• patiromer (veltassa)
• SPS- sodium polystyrene sulfonate,

Question 21

what drugs shif K intracellularly

Answer 21

• dextrose
• insulin
• albuterol
• sodium bicarb

Question 22

complication of CKD

Answer 22

metabolic acidosis

Question 23

what type of meds can be clearedd easily by dialysis

Answer 23

smaller drugs

Question 24

loop diuretics work in the

Answer 24

ascending loop

Question 25

electrolyte imbalance

Answer 25

potassium first by giving calcium gluconate

Question 26

calcitrol is which vitamin

Answer 26

D3