Renal Drugs (AKI, CKD)

Question 1

List the 6 types of Classes of drugs used to treat renal failure,

What are the symptoms of Renal failure that we are targeting to treat?

Answer 1

(1) Erythropoietin; Erythropoiesis-stimulating agents
(2) Potassium binder
(3) Calcium-based phosphate binders
(4) Vitamin D: Supplements for Mineral and bone disorders; help to absorb calcium

(5) Loop diuretic
(6) Sodium Bicarbonate

Question 2

List the MOA, Rationale and A.E.
for 1 class of drug used to treat symptoms of renal failure.
–> Anemia

Answer 2

Drug: Epoetin alfa (SC, IV)

Class: Erythropoietin; Erythropoiesis-stimulating agents
MOA: Stimulate erythropoiesis
Rationale: Anaemia
A.E.: Headache, fever, nausea, diarrhoea, insomnia, cough, URTI, oedema
**Hypertension, seizures, heart failure, MI, stroke **

Question 3

List the MOA, Rationale and A.E.
for 1 class of drug used to treat symptoms of renal failure.
–> Hyperkalemia

Answer 3

Drug: Sodium polystyrene sulfonate, Sodium zirconium cyclosilicate (PO or rectal)

Class: Potassium binder

MOA: Bind to the excess potassium in the bowels –> excreted from the body through the stool.

Capture potassium in exchange for calcium or sodium ions found in the colon
Rationale: Hyperkalaemia

A.E.: Oedema, Hypokalaemia, Constipation, Diarrhoea, Fecal impaction,
Nausea, Vomiting, Low calcium and magnesium level, Retention of sodium ions, Abdominal discomfort, Bloating

Hyperkalemia Kit
(1) Calcium glucalate
(2) IV insulin
(3) Dextrose

Question 4

List the MOA, Rationale and A.E.
for 1 class of drug used to treat symptoms of renal failure.
–> Hyperphosphatemia

Answer 4

Drug: Calcium carbonate,
Calcium acetate,
Sevelamer,
Lanthanum (PO)

Class: Calcium-based phosphate binders

MOA: Kidneys excrete 90% of daily phosphate load.
Patients with kidney problems can’t regulate phosphate levels.

Rationale: To prevent or to treat calcium deficiency and also treat
hyperphosphatemia

A.E.: Oedema, Hypophosphatemia, Constipation, Abdominal discomfort, Bloating

Question 5

List the MOA, Rationale and A.E.
for 1 class of drug used to treat symptoms of renal failure.
–> Hyperparathyroidism

Answer 5

Drug: Calcitriol, Cinacalcet (PO, iv)

Class: Vitamin D: Supplements for Mineral and bone disorders; help to absorb calcium

MOA: An active form of vitamin D3
–> elevates the plasma levels of calcium
–> stimulating intestinal calcium uptake, increasing reabsorption of calcium by the kidneys.

Rationale: To treat hyperparathyroidism (overactive parathyroid glands) and metabolic bone disease in people who have chronic kidney failure and are not receiving dialysis.

A.E.: Constipation, bone pain, excessive night-time urination, high calcium, magnesium and phosphates, BUN and creatinine increase, Cardiac arrhythmias

Question 6

List the MOA, Rationale and A.E.
for 1 class of drug used to treat symptoms of renal failure.
–> Fluid Overload

Answer 6

Drug: *Furosemide (PO, IV, IM)

Class: Loop diuretic
- Potassium wasting loop diuretic
- Acts by inhibiting the luminal Na-K-Cl cotransporter in the thick ascending limb of the loop of Henle
–> binding to the chloride transport channel
–> more sodium, chloride, and potassium to stay in the urine.

Rationale: Reduce Volume overload

A.E.: Minor hypokalaemia, postural hypotension, tinnitus, nausea, diarrhoea, dizziness, fatigue, Significant hypokalaemia, blood dyscrasias, dehydration, ototoxicity, electrolyte imbalance, circulatory collapse

Question 7

List the MOA, Rationale and A.E.
for 1 class of drug used to treat symptoms of renal failure.
–> Metabolic Acidosis

Answer 7

Sodium bicarbonate