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Renal/Resp > Renal Pharm > Flashcards

Renal Pharm Flashcards

1
Q

What ist he treatment for anemia in chronic kidney disease?

A

Epoetin – IV or subcut

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2
Q

What are the side effects of epoetin?

A 
nausea
headache
influenza
HTN
Thrombosis of arteriovenous shunts
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3
Q

How do you treat secondary hyperparathyroidism in chronic kidney disease?

A

calcitriol and vitamin D analogs

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4
Q

What is the mechanism of action of calcium and vitamin D analogs?

A

enhancement of absorption of calcium and PO4 from intestine

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5
Q

What are the unwanted effects of calcitriol?

A

excessive dosing leads to hypercalcemia

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6
Q

What are phophate binders?

A

calcium carbonate
calcium acetate
lanthanum carbonate
seelamer

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7
Q

What is the biphosphonates used for?

A

prophosphate analogues that bind to hydroxyapatitie crstals in bone matrix to treat hypercalcemia

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8
Q

What are the unwanted side effects of bisphosphonates?

A

GI disturbance, abdominal pain, nausea

osteonecrosis of jaw

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9
Q

What is calcitonin?

A

produced by parafollicular or C cells of thyroid gland
secreted when calcium levels rise
main action is lowering of plasma calcium by limiting bone resorption and increases phosphate secretions

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10
Q

What are the side effecs fo calcitonin?

A

facial flushing
headache
GI
Taste disturbance

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11
Q

What is rasburicase used to treat?

A

recombinant version of enzyme urate oxidase

used as prophylaxis during chemo

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12
Q

What are the unwanted side effects of rasburicase?

A

fever
nausea
HSN
hemolysis-due to hydrogen peroxide

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13
Q

What are calcineurin inhibitors used to treat?

A

decrease T cella ctivationa nd proliferation, to lower immune reaction or prevent organ rejection

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14
Q

What is the mechanism of action of tacrolimus?

A

macrolide that bind to and inhibit calcinuerin; inhibits transcripton of cytokines and IL2

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15
Q

What are the side effects of cyclosporine?

A 
nephrotoxicity
HTN and fluid rentetion
hepatic dysfunction
tremor, headache, fatigue
GI
hypertrichosis
Gum hhypertrophy
hyperlipidemia
hypomagnesia
hypokalemia
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16
Q

What are the side effecs of Tacrolimus?

A

doesnt stim TGFBeta
pleural and pericardial effusion
cardiomyopathy

17
Q

What ist he mechanism of action fo siroloimus?

A

bidns to FKB12 and acts to modulate the mechanism of mTOR; inhibiitin cytokin/IL2 induced cell cycle progression

18
Q

What are the side effects of sirolimus?

A 
edema, ascites, HTN
GI
hyperlipidemia
hypokalemia
hypophosphatemia
lymphocele
rash
drug interactions
19
Q

What are the benefits of siroloimus?

A

protent phrophylaxis against cellular rejection
less vasocontriction
not associated with acute or chronic renal insufficiency

20
Q

What is the mechanism of action of mycophenolate mofetil?

A

competitive, reversible inhibition of IMPDH a critical rate-limiing enzyme in de novo purine synthesis

lymphocytes dependent on de novo pathway

inhibits proliferation of B + T lymphocytes

21
Q

What are the unwanted side effect of mycophenolate mofetil?

A 
HTN, edema, tachy
dyspnea, cough
dizziness, insomnia, termor, seizures
leucopenia, thrombocytopenia, anemia
opportunistic infections
lymphoproliferative disease
22
Q

What is the mechanism of action of azathioprine?

A

purine analogue
metabolized in liver to 6-mercaptopurine and tehn to TIMP
blocks CD28 costim of T cells

23
Q

What is the mechanism of action of basiliximab?

A

anti-CD25 antibody; blocks IL2 receptor antibody

24
Q

What is the mechanism of action of belatacept?

A

fusion protein binds CD80 and CD86; blocks co stim action

25
Q

What is teh role for belatacept?

A

used for renal transplantation in patients seropsoivitve for EBV

26
Q

What is the unwanted side effects for belatacept?

A

HSN reaction rarely occur

lymphoproliferative disorder in those with no prior exposure to EBV

27
Q

What is the side effects of prednisolone?

A 
acne
cushingoid
hirsutism
mood disorder
HTN
glucose intolerance
cataracts
osteoporosis
growth retardation in children
28
Q

What are the induction agents role in combating kindye transplant rejection?

A

monoclonal or polyclonal antibody

admin IV imediately following surgery

29
Q

What are the maintenance agents for combatting kidney tranplant rejection?

A

prednisolone
calcineurin inhibitor
anti-proliferative agents
triple agents

Renal/Resp (22 decks)

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