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Pharmacology > Renal Drugs > Flashcards

Renal Drugs Flashcards

1
Q

Diuretic that is preferred in patient with mild renal insufficiency

A

HCTZ

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2
Q

JNC8 guidelines for treating HTN

A

treat when 150/90 in 60+ or 140/90 in <60 y/o

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3
Q

what can be used for kidney stone prevention

A

thiazide diuretics

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4
Q

S/E of thiazide diuretics

A
  1. hypokalemia

2. drug interaction with bile acid binding resins

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5
Q

what labs and how often do you check them when on thiazide diuretic

A

BMP, CBC every 3-4 months

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6
Q

loop diuretics increase renal excretion of what?

A

water, Na, Cl, Mg, K, Ca

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7
Q

what do you have to give in addition to loop diuretic

A

PO potassium

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8
Q

What labs do you check with loop diuretics and when?

A

prior to starting and regularly throughout treatment

electrolytes, BUN, creatinine, LFTs, uric acid, glucose

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9
Q

diuretics increase risk of….

A

gout

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10
Q

potassium sparing diuretics can be used off label for…

A

acne

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11
Q

indications for carbonic anhydrase inhibitors

A

glaucoma
acute mountain sickness
pseudotumor cerebri

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12
Q

S/E carbonic anhydrase inhibitors

A

tingling, kidney stones

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13
Q

DDAVP is used for…

A

bedwetting

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14
Q

DDAVP increases risk for….

A

clots

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15
Q

Indications for anticholinergics

A 
symptoms of overactive bladder
urge incontinence (but not stress incontinence)
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16
Q

Anticholinergic CIs

A

cognitive impairment

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17
Q

Anticholinergic S/E

A 
hots as hare
blind as a bat (blurred vision)
dry as a bone (constipation, dry mouth)
red as a beet (flushing)
mad as a hatter (delerium) 
bloated as a toad (ileus)
the heart runs alone (tachycardia)
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18
Q

labs to check prior to starting anticholinergic

A

urine and urine culture

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19
Q

Alpha-1-antagonist examples

A

tamsulosin / flomax

terazosin / hytrin

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20
Q

Alpha-1-antagonist indications

A

BPH

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21
Q

Alpha-1-antagonist S/E

A 
orthostatic hypotension!
headache
somnolence
nasal congestion
palpitations
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22
Q

Prazosin is used off-label for

A

nightmares

23
Q

PDE5 Inhibitors absolute CI

A

patients using nitrates

24
Q

osmotic diuretics example

25
Q

osmotic diuretics MOA

A

reduces reabsorption of water in proximal convoluted tubule and thin descending Loop of Henle, increases excretion of almost all electrolytes

26
Q

osmotic diuretics indications

A
  1. increased intracranial pressure, cerebral edema
  2. glaucoma
  3. acute renal failure
27
Q

osmotic diuretics CI

A
  1. acute cranial bleeding

2. continuous administration

28
Q

osmotic diuretics S/E

A
  1. pulmonary edema

2. dehydration and hypernatremia

29
Q

what should be monitored when giving an osmotic diuretic

A
  1. vital signs
  2. urinary output
  3. pulmonary pressure
  4. electrolytes
30
Q

Desmopressin (DDAVP) MOA

A

increases resorption of water by increasing the permeability of collecting ducts in kidney, decreasing urinary output

31
Q

DDAVP Indications

A
  1. decrease urine production

2. help reduce bleeding

32
Q

DDAVP CIs

A
  1. hypersensitivity

2. mild to moderate renal impairment

33
Q

DDAVP cautions

A

should be used sparingly (ie overnight trip)

can develop hyponatremia

34
Q

DDAVP S/E

A
  1. acute MI
  2. thrombosis
  3. increased BP
  4. water intoxication
  5. confusion
  6. seizures
35
Q

Anticholinergic examples

A
  1. oxybutynin / ditropan or oxytrol patch
  2. tolterodine / detrol
  3. solifenacin / vesicare
36
Q

Anticholinergic indications

A

overactive bladder w/ urge urinary incontinence, urgency, frequency

37
Q

Anticholinergic MOA

A

block muscarinic and parasympathetic nerve endings on detrusor muscle of bladder

38
Q

Anticholinergic CIs

A
  1. conditions in which cholinergic blockade would exacerbate an already serious problem
  2. avoid in Alzheimer’s disease
39
Q

beta-3 adrenergic agonist example

A

Myrbetriq / mirabegron

40
Q

beta-3 adrenergic agonist indication

A

overative bladder w/ urge urinary incontinence, urgency, frequency

41
Q

beta-3 adrenergic agonist MOA

A

targets beta-3 adrenergic receptor pathway, impacts storage phase of micturition cycle

42
Q

beta-3 adrenergic agonist CI

A
  1. caution w/ bladder outlet obstruction

2. caution with anti-muscarinic medications

43
Q

beta-3 adrenergic agonist S/E

A
  1. hypertension
  2. nasopharyngitis
  3. UTI
  4. headache
  5. angioedema
44
Q

alpha-1 antagonist MOA

A

vasodilation and decreased systemic vascular resistance

relax urinary sphincter

45
Q

alpha-1 antagonist CI

A

concurrent use w/ any PDE5 inhibitor (ie Viagra)

–> increased risk of severe hypotension

46
Q

Why is tamsulosin good?

A

more selective for alpha 1a receptors on bladder sphincter, not vascular smooth muscle –> less risk of orthostatic hypotension

47
Q

5-alpha-reductase inhibitors example

A

finasterid / proscar / propecia

48
Q

5-alpha-reductase inhibitors MOA

A

reduce production of DHT (active form of testosterone)

49
Q

5-alpha-reductase inhibitors indications

A

BPH

male pattern baldness

50
Q

5-alpha-reductase inhibitors CIs

A

pregnancy (category X)

women of childbearing age

51
Q

5-alpha-reductase inhibitors S/E

A
  1. postural hypotension
  2. dizziness
  3. sexual dysfunction
52
Q

cautions with 5-alpha-reductase inhibitors

A

they lower PSA, can mask elevations associated with malignancy

53
Q

PD5-Inhibitor examples

A
  1. sidenafil / viagra
  2. tadalafil / cialis
  3. vardenafil / levitra
54
Q

PD5-Inhibitor MOA

A

improves ability to attain and maintain an erection by enhancing vasodilating effect of nitrous oxide, increasing cGMP to allow smooth muscle relaxation and inflow of blood

Pharmacology (27 decks)

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