Renal Drugs Flashcards
what are some examples of thiazide diuretics?
Bendroflumethazide
Indapamide
Chlortalidone
what is the MoA for thiazide diuretics?
Inhibit Na+/Cl- transporter at the distal convoluted tubule and collecting duct
Increases Na+, Cl- and water excretion
What are the indications for thiazide diuretics?
hypertension
oedema of cardiac, renal, hepatic, iatrogenic origin
list some side effects of thiazide diuretics:
Hypokalaemia Hypomagnesaemia Hyponatraemia Hypercalcaemia Hyperuricaemia Reduced glucose tolerance Hypersensitivity reactions – rashes, pneumonitis (less common)
what is important clinically regarding pharmacokinetics/dynamics for thiazide diuretics?
Produces diuresis quickly within 1-2 hours
NSAIDs reduces efficacy of thiazide diuretics
What info needs to be given to patient before starting a thiazide diuretic?
Urinary frequency usually not affected
Report if sudden rash
Make aware of risk of electrolyte imbalance
what are some examples of Loop Diuretics?
Furosemide
Bumetanide
Torasemide
what is the MoA for loop diuretics?
Na+/Cl-/K+ symporter antagonists
Act on the thick ascending loop of Henle
Increase secretion of Na+, K+, Cl- and water
what are the indications for a loop diuretic?
Hypertension Hyperkalaemia Heart failure Cirrhosis of liver (fluid retention) Nephrotic syndrome
list some side effects of a loop diuretic?
Hypokalaemia, hypovolaemia, hyperuricaemia (increased urate reabsorption)
Metabolic acidosis
Abdominal pain
Ototoxicity
what is important clinically regarding pharmacokinetics/dynamics for loop diuretics?
60% absorbed in patients with normal renal function
Renal and hepatic excretion – increased half life for patients with renal or hepatic disease
What info needs to be given to patient before starting a loop diuretic?
Avoid excess alcohol
Urinary frequency increases
what are some examples of insulin?
Novorapid
Glargine
Humalog Mix
what is the MoA of insulin?
Insulin increases cellular uptake of glucose.
It stimulates glycogenesis, encourages DNA synthesis and promotes release of GH.
Several types of exogenous insulin:
Short acting: Novorapid
Long acting: Glargine
Fast-acting and Intermediate-acting mix: Humalog Mix
what are the indications for insulin?
T1DM
T2DM
Hyperkalaemia
what are the side effects of insulin?
Hypoglycaemia
Sweats / shakes / tachycardia / headache / weakness / fatigue (typically symptoms of hypoglycaemia)
Oedema
Injection site reactions
what is important clinically regarding pharmacokinetics/dynamics for insulin?
Patients are given varying types of insulin combinations based on their activities and preferences.
Given subcutaneously and short acting insulin (actrapid) can be given intravenously.
What info needs to be given to patient before starting insulin?
Only in the form of injection
Compliance important
Never skip meals while on insulin
When does rapid acting insulin (Novorapid) reach circulation & peak and how long does it last?
Reaches circulation within 15 minutes after injection
Peaks 30 to 90 minutes later
Lasts for up to 5 hours
When does short acting insulin reach circulation & peak and how long does it last?
Reaches circulation 30 mins after injection
Peaks 2 – 4 hours later
Lasts for up to 4 to 8 hours
When does intermediate acting insulin reach circulation & peak and how long does it last?
Reaches circulation in 2 – 6 hours
Peaks 4 – 14 hours later
Lasts for up to 20 hours
When does long acting insulin (Glargine) reach circulation & peak and how long does it last?
Reaches circulation in 6 to 14 hours
Minimal peak
Lasts for up to 24 hours
