Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal Exam > Renal Pharmacology > Flashcards

Renal Pharmacology Flashcards

1
Q

Want to do some drugs?

A

Obviously, you’re studying this deck.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What kinds of drugs have high incidence of acute kidney injury?

A

patients receiving antibiotics, chemotherapy, or radiocontrast dyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do you usually treat AKI?

A

Current treatment involves fluid and blood pressure maintenance and hemodialysis. No drugs on market for treating acute kidney injury.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What categories of drugs are emerging to treat AKI since it is caused by ischemia and reperfusion injury?

A
  1. anti-apoptotic
  2. anti-inflammatory
  3. anti-sepsis
  4. growth factor
  5. vasodilator
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some anti-apoptotic drugs for AKI?

A

Caspase inhibitors

Minocycline (antibiotic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some anti-inflammatory drugs for AKI?

A

Adenosine A2A agonist

Phosphatidylserine binding protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some anti-sepsis drugs for AKI?

A

Insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some growth factors drugs for AKI?

A

Recombinant erythropoietin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some vasodilator drugs for AKI?

A

Fenoldopam (dopamine)

Atrial natriuretic peptide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of CKD are what?

A
  • Diabetic Nephropathy
  • Hypertension
  • Glomerulonephritis
  • HIV nephropathy
  • Reflux nephropathy in children
  • Polycystic kidney disease
  • Kidney infections & obstructions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do Renin-Angiotensin Inhibitors help in CKD?

A

↓ Progression of albuminuria
↓ Progression of GFR decline
↓ Risk of ESRD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some beneficial effects of RAAS inhibitors?

A
  • Only in part due to blood pressure reduction
  • Extend to CKD regardless of etiology
  • Occur with both ACE inhibitors and ARBs
  • At recommended doses, ACEI + ARB better than either alone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What about NSAIDs in CKD?

A

– Damage kidneys further

– May interact with ACE inhibitors and angiotensin receptor antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does treatment of Diabetic Nephropathy in a pt with CKD help?

A

Management of primary disorder paramount: Good glycemic control (HbA1c < 7%), Blood pressure control Goal < 140/90 mmHg, Medications to minimize proteinuria – ACEI & ARB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anemia occurs in CKD how can we help this?

A

Erythropoietin (hormone)

Epoetin (drug)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Erythropoietin?

A

glycosylated protein hormone produced primarily in the kidney that regulates red blood cell production by reducing apoptosis and stimulating differentiation and proliferation of erythroid progenitor cells and is deficient in ESRD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Human recombinant synthesized erythropoietin?

A

Epoetin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How is Epoetin administered?

A

IV or SubQ: Response more rapid with i.v. but greater response with subcutaneous
• Epoetin half-life 4-6 hours
• Administered 2-3 times / week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Side effects of Epoetin?

A

• Nausea, vomiting, diarrhea
• Headache
• Influenza-like symptoms early in treatment
• Hypertension – dose-dependent
• Thrombosis of arteriovenous shunts
** Pure red cell aplasia subcutaneous administration in renal failure associated with antibodies of epoetin – must discontinue treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Plasma calcium is regulated by what 3 hormones?

A

Parathyroid hormone, calcitonin, and Calcitriol (active vit. D)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What forms does calcium take in the plasma?

A

40% is bound to plasma protein –albumin, 10% complexed with citrate, carbonate and phosphate and 50% is free ionized an important form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Kidney failure disrupts systemic calcium and phosphate homeostasis and affects what organs?

A

the bone, GI tract, and parathyroid glands

23
Q

What does calcitriol do?

A

Calcitriol increases serum calcium levels

24
Q

The increased phosphate and reduced calcium, feedback and can lead to what?

A

Secondary hyperparathyroidism which has increased PTH

25
What major factors can lead to Secondary | hyperparathyroidism?
– Decreased production of Vitamin D3 (calcitriol) – Decreased serum calcium – Increased serum phosphorous
26
What are some Vitamin D analogs?
Calcitriol Alafacalcidol Paricalcitol Ergocalciferol
27
How do vitamin D analogs help with CKD?
* Enhancement of absorption of Calcium and PO4 from intestine * Calcitriol also enhances recruitment and differentiation of osteoclast precursor for remodelling - resorption of Calcium and PO4 from bone * Also enhances renal tubular reabsorption of Calcium
28
In CKD why do hydroxylated forms of vitamin D need to be used?
hydroxylation of vitamin D occurs in the kidney and the hydroxylated forms are active (alfacalcidol or calcitriol) Ergocalciferol is inactive
29
Which vitamin D analogs have short half lives and which needs to be injected?
* Alafacalcidol and calcitriol have short half-lives (3 hours) * Paricalcitol requires i.v. injections
30
What are side effects of vitamin D analogs?
excessive dosing leads to hypercalcemia
31
What are some phosphate binder drugs?
Calcium carbonate Calcium acetate Lanthanum carbonate Sevelamer
32
How do phosphate binding drugs work?
GI – Phosphate absorption by reacting with phosphate and form insoluble compound
33
How is Sevelamer different than the other phosphate bindners?
it has a calcium and aluminum free polymeric structure
34
What are side effects of phosphate binders?
GI side effects / hypercalcemia
35
How do you get Hypercalcemia and Kidney Disease?
* Prolonged kidney disease can be associated with hypercalcemia * Renal transplant patients can have parathyroid hyperplasia and restoration of renal function and calcitriol production can lead to hypercalcemia
36
How could you treat the hypercalcemia?
Bisphosphonates & Calcitonin
37
What are the two bisphosphonates we have to know?
Etidronate (1st gen) & Zoledondrate (3rd gen)
38
How do Bisphosphonates work?
pyrophosphate analogues that bind to hydroxyapatite crystals in bone matrix to inhibit bone resorption
39
How should bisphophonates be administered?
* Actions are relatively short-lived and need to be administered weekly * Zoledondrate can suppress bone resorption for up to a year after a single dose
40
What are some side effects of bisphophonates?
GI disturbances, abdominal pain, nausea, Osteonecrosis of jaw (i.v.)
41
What is calcitonin?
* Produced by parafollicular or C cells of the thyroid gland | * Secreted when plasma calcium level rises
42
How does calcitonin work?
• Main action is the lowering of plasma calcium by limiting bone resorption and it increases phosphate excretion in the urine
43
How do you administer calcitonin?
Intramuscular or subcutaneous injection – half-life ~20 minutes
44
What are some side effects of calcitonin?
* Facial flushing in most patients * Headache - Dizziness * GI – nausea, vomiting, abdominal Pain, diarrhea * Taste disturbance
45
Hyperuricemia can occur with CKD since the kidneys eliminate uric acid what drugs can be used to help with this?
Colchicine Allorpurinol Febuxostat Rasburicase
46
Which hyperuricemia drugs can you not use in pt with CKD?
Sulfinpyrazone & Probenecid because they increase uric acid clearance via the kidney
47
What does colchicine do?
* Reduces inflammation * Given every 6-12 hours to relieve symptoms * Pain relief begins at about 18 hours and is maximal by 48 hours
48
What are some side effects of colchicine?
GI Toxicity | Rash
49
What are the oral Xanthine Oxidase Inhibitors?
Allorpurinol: purine Febuxostat: non- purine
50
How do Xanthine Oxidase Inhibitors work?
Competitive enzyme inhibitors with Variable half-life 1-15 hours (d/t renal excretion)
51
What are some side effects of Xanthine Oxidase Inhibitors?
GI upset Risk of acute gout – release of uric acid from tissue deposits Hypersensitivity to allopurinol –rashes especially in renal disease patients Drug interactions – inhibit metabolism of azathioprine
52
How does rasburicase work?
Recombinant version of enzyme urate oxidase breaks down uric acid
53
How is rasburicase metabolized and administered?
* Metabolized by peptide hydrolysis in plasma | * Used primarily as prophylaxis during chemotherapy (can be used in CKD)
54
What are some side effects of rasburicase ?
Fever Nausea, vomiting, diarrhea Hypersensitivity – allergic reactions anaphylaxis (rare) Hemolysis – due to hydrogen peroxide production as a by product of allantoin

Renal Exam (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions