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Renal Pharmacology > Renal Pharm > Flashcards

Renal Pharm Flashcards

1
Q

Phosphate-binding drugs?

A

Selevamer

CaCO3

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2
Q

Vitamin D analogue?

A

Calcitriol

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3
Q

Calcimemetic?

A

Cinacelcet

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4
Q

Primary function to maintain constant Ca+ concentration in ECF in response to plasma Ca+ concentration

A

PTH

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5
Q

Starting with this stage of CKD, you have a decreased renal phosphorus excretion (so elevated serum phosphate) and decreased vitamin D activation: Decreased GI Ca absorption so decreased serum Ca+ concentration

A

Stage 3 CKD

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6
Q

Released to:

  • Increase Ca+ resorption from bone and in PCT
  • Decrease phosphorus resorption in PCT
  • Increase activation of Vitamin D to increase GI Ca+ absorption and mobilization of Ca+ from bone
A

PTH

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7
Q

Low serum Ca+ and increased phosphorus cause increased PTH levels and….

A

sHPT

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8
Q

Calcium based phosphate binder

A

CaCO3

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9
Q

For use in CKD with hyperphosphatemia; Binds to phosphorus in GI tract and is excreted

A

CaCO3

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10
Q

For use in HYPERPHOSPHATEMIA; non-absorbed phosphate binder that prevents phosphorus absorption, promoting excretion

A

Sevelamer

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11
Q

Can also reduce LCL-C up to 30%; Very expensive!

A

Sevelamer

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12
Q

Activated Vitamin D; used for reduction of PTH levels and hypocalcemia in ESRD

A

Calcitriol

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13
Q

Up-regulates Vit D receptor on PT gland, decreasing gland hyperplasia and PTH synthesis

A

Calcitriol

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14
Q

Also up-regulates GI Vit D receptors, increasing Ca+ and phosphorus absorption

A

Calcitriol

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15
Q

Calcimemetic; used for elevated serum PTH, Ca+ and Ca-P product (in dialysis pts only!!)

A

Cinacalcet

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16
Q

Reduces PTH secretion by sensitizing PT gland Ca+ receptors (mimicking the action of Ca+ at receptor) lowering Ca+ and phosphorus levels.

A

Cinacalcet

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17
Q

Caution of use in patients with seizure disorder! Useful for pts who can’t use Vit D

A

Cinacalcet

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18
Q

Thiazide diuretics used for HTN, edema in nephrotic syndrome; off-label use in lithium induced DI; Loses effectiveness at GFR

A 
HCTZ
Chlorthalidone (2x potency)
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19
Q

Na-Cl symporter inhibition in the DCT increasing Na and Cl excretion to max 5% of filtered NaCl

A 
Thiazide Diuretics:
HCTZ
Chlorthalidone
Metolazone (SA)
Indapamide (LA)
20
Q

Chronic use decreases Ca+ excretion & can increase serum uric acid levels

A

Thiazide diuretics

21
Q

Secreted into renal tubule via active transport in PCT (organic acid pathway); NSAIS interfere with this secretion

A

Loop Diuretics

22
Q

Used for edema secondary to CHF, Renal failure, liver failure; Inhibits Na+-K+-2Cl- symporter in TAL & distal tubule

A

Loop diuretics

23
Q

Erythropoesis stimulation agent; Growth Factor-stimulates erythroblasts to proliferate and differentiate into normoblasts, then reticulocytes

A

Epoetin alfa (Epogen)

24
Q

Magnesium supplement; indicated in hypomagnesemia (also with low K+ and low Ca+ also)

A

MgCl

25
Q

Potassium supplement; indicated in hypokalcemia

A

KCl

26
Q

PGE2 causes dilation and AT2 causes constriction

A

Afferent arteriole

27
Q

AT2 causes constriction

A

Efferent arteriole

28
Q

Inhibits PGE production resulting in unopposed afferent renal arteriole AT2 impact–> vasoconstriction & interferes with PGE modulated inhibition of Na and Cl-reabsorption

A

NSAIDs

29
Q

Causes renal vasoconstriction

A

cyclosporine

30
Q

Cause an osmotic diuresis; Renal injury may include direct tubular toxicity, renal ischemia, tubular obstruction

A

Ionic contrast materials

31
Q

If you must use ionic contrast materials, you must expand EC volume with…

A

isotonic NaCl solution

32
Q

One of the first classes of diuretics discovered

A

Carbonic anhydrous inhibitors

33
Q

Carbonic anhydrase inhibitor; used in glaucoma and altitude sickness

A

Acetozolamide

34
Q

Reversibly blocks carbonic anhydrase in PCT maintaining NaHCO3 in tubule lumen, resulting in diuresis

A

Acetozolamide

35
Q

Thiazide diuretics that DON’T lose effectiveness at GFR

A

Metolazone & Indapamide

36
Q

K+ Sparing diuretics

A

Spironolactone
Eplenerone
Amilloride
Triamterine

37
Q

K+ sparing agent; synthetic steroid that competitively antagonizes aldosterone; Metabolized by the liver

A

spironolactone

38
Q

K+ sparing agent; spironolactone analogue with much greater mineralocorticoid receptor selectivity

A

Eplenerone

39
Q

K+ sparing agent; direct inhibitor of Na+ influx (and corresponding K+ secretion) in cortical collecting tubule and ducts (DOESN’T BLOCK ALDOSTERONE)

A 
Amiloride 
Triamterene (shorter T1/2)-more freq dosing
40
Q

Can decrease myocardial fibrosis

A

Spironolactone & Eplenerone

41
Q

CYP34A substrate; more selective for mineralocorticoid receptor and so fewer SE than spironolactone

A

Eplenerone

42
Q

Used in combo with Thiazide diuretics

A

Amiloride & Triamterine

43
Q

Administerd IV for systemic effect (not absorbed orally and oral use causes osmotic diarrhea)

A

Mannitol

44
Q

Not metabolized; filtered via glomerulus; exerts osmotic force in PCT and DL of Loop of Henle decreasing water reabsorption

A

Mannitol

45
Q

Osmotic diuretic; used for reduction of intracranial or intraocular pressure and rhabdomyolysis; Works by osmosis producing increased water loss

A

Mannitol

Renal Pharmacology (1 decks)

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