Renal Failure

Question 1

Medications like Captopril and Enalapril belong to what class of medications?

Answer 1

ACE inhibitors

Question 2

What are adverse effects of ACE inhibitors?

Answer 2

Hypotension
Cough
Proteinuria, taste disturbance (Captopril)
Reversible renal impairment (Enalapril)

Question 3

What class of medications do Valsartan and Losartan belong to?

Answer 3

Angiotensin receptor blockers (ARBs)

Question 4

What adverse effects are seen with ARBs?

Answer 4

Hypotension
Reversible renal impairment
Teratogenic

Question 5

Calcitriol, Calcipotriol, and Tacalcitol belong to what class of medications?

Answer 5

Vitamin D analogues

Question 6

What effect do Vitamin D analogues have in treating renal failure?

Answer 6

Manage secondary hyperparathyroidism

Question 7

Diuretics can be used in the treatment of renal failure. Which class should be used with caution in people with chronic renal failure?

Answer 7

Potassium-sparing diuretics, such as aldosterone antagonists

Question 8

To which class of medications do Epoetin Alfa and Darbepoetin Alfa belong?

Answer 8

Hematopoietic growth factors

Question 9

What are hematopoietic growth factors used for in patients with renal failure?

Answer 9

Erythropoietin-stimulating activities provide increased red blood cell production, which is often decreased in renal failure patients

Question 10

What is hyperphosphatemia (blood phosphates > 1.46mM or 4.5 mg/dL) a hallmark of?

Answer 10

Chronic kidney disease

Question 11

What medications can induce hyperkalemia?

Answer 11

K+ sparing diuretics (spironolactone)
NSAIDs
ACE inhibitors

Question 12

What 3 medications bind phosphate in the GI tract and what negative effects are associated with them?

Answer 12

Aluminum hydroxide (can cause aluminum toxicity in dialysis patients)
Calcium carbonate (can cause hypercalcemia and accelerated vascular calcification, if patient is not hypocalcemic)
Sevelamer hydrochloride (less binding capacity, GI disturbances, and reduces bioavailability of fat-soluble vitamins)

Question 13

What 3 medications exist for treatment of hyperkalemia?

Answer 13

Sodium (or calcium) polystyrene sulfonate
Glucose and Insulin
Salbutamol

Question 14

What is desmopressin used to treat?

Answer 14

Nocturnal enuresis in children

Question 15

How does desmopressin work?

Answer 15

Desmopressin stimulates V2 receptors,which activate aquaporins, facilitating water reabsorption.

Question 16

What are the adverse effects of desmopressin?

Answer 16

Water intoxication (hyponatremia)
Hypotension (IV administration)

Question 17

Which muscarinic receptor is targeted in treatment of enuresis?

Answer 17

M3

Question 18

Darifenacin and solifenacin differ from oxybutinin and tolterodine in what manner in the treatment of enuresis?

Answer 18

The former two are M3 selective, whereas the latter two are nonselective muscarinic antagonists

Question 19

How do M3 antagonists stop enuresis?

Answer 19

Antagonism of M3 receptors prevents contraction of the detrusor muscle of the bladder, which facilitates emptying

Question 20

What receptor does Mirabegron act on?

Answer 20

Beta-3 adrenoceptors

Question 21

How does agonism of beta-3 adrenoceptors work to treat enuresis?

Answer 21

It induces relaxation in the detrusor muscle of the bladder, increasing bladder capacity

Question 22

What are adverse effects that are seen with the use of Mirabegron?

Answer 22

Increased blood pressure
Bladder pain
Dry mouth
Headache
Dizziness