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Therapeutics > Renal Products > Flashcards

Renal Products Flashcards

1
Q

Elemental Iron in Ferrous sulfate 325mg:

A

65mg

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2
Q

Elemental iron in ferrous gluconate 325mg:

A

36mg

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3
Q

Elemental iron in Niferex forte 150mg:

A

150mg

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4
Q

Recommended elemental iron

A

~200mg elemental iron/day

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5
Q

What enhances iron absorption?

A

Ascorbic acid

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6
Q

Side effects of oral iron:

A
  • abdominal cramping
  • constipation
  • nausea
  • Others: esophagitis, esophageal ulceration
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7
Q

Drug interactions for oral iron:

A
  • Acid suppressing agents
  • Oral quinolones (take 4hrs before or 8hrs after iron)
  • oral tetracyclines (take 1 hr before or 4-6hrs after iron)
  • Ca, Al, Mg containing products
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8
Q

Iron dextrans BBW:

A

Highest level of anaphylaxis

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9
Q

Dosing of ferric gluconate

A

IV only. 125mg/dose at each dailysis session for a total of 8 sessions

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10
Q

Dosing of iron sucrose

A

IV only;
Dialysis: 100mg/dose at each dialysis session for a total of 10 sessions
Non-dialysis: 200mg/dose for a total of 5 doses in a 14 day period

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11
Q

Dosing of ferumoxytol

A

IV only;

Dialysis & non-dialysis: 510mg dose then repeat 510mg 3-8 days later

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12
Q

Adverse effects of IV Iron products

A
  • allergic rxns (mostly iron dextran)
  • hypotension, dizziness, syncope
  • Dyspnea
  • HA
  • back pain
  • Arthralgia
  • Rash, pruritis
  • Nausea
  • increased risk of bacterial infection
  • injection site rxn
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13
Q

Iron Overload

A
  • aka hemochromatosis
  • No physiologic mechanism for iron excretion
  • HD patients at highest risk
  • causes fatigue, joint pain, and liver failure
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14
Q

Iron toxicity

A

Overwhelm iron binding proteins leading to free iron in blood –> oxidative stress –> CV disease

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15
Q

Epoetin alfa doses

A

Dialysis & non-dialysis: 50-100 units/kg given 3x/week (IV preferred or SQ)

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16
Q

Darbepoetin doses

A

Dialysis: 0.45mcg/kg IV or SQ weekly; 0.75mcg/kg IV or SQ Q2 weeks
Non-dialysis: 0.45mcg/kg IV or SQ Q4 weeks

17
Q

Adverse effects associated with ESAs

A
  • expansion of blood volume
  • Increased blood viscosity
  • Reversal of hypoxic vasodilation
  • HTN
  • arthralgias/HA
  • muscle spasms
  • dizziness
  • injection site rxn
  • Fever
  • dyspnea (darbepoetin)
18
Q

Additional Epoetin BBWs

A
  • perisurgery: due to increased risk of DVT, DVT prophylaxis is recommended.
19
Q

BBW for all ESAs

A
  • Patients w/ CKD are at higher risks for CV events when you target/achieve Hgb > 11g/dL
20
Q

How long is an open, multidose vial of ESA good for if kept in the fridge?

A

21 days

21
Q

Drug interactions with calcium acetate?

A
  • Oral quinolones: separate administration by 1-2hrs

- oral tetracyclines: separate by 1-2hrs

22
Q

Sevelamer (Renvela) drug interactions

A

Give ALL other medications 1hr before or 3hrs after

23
Q

Sevelamer adverse effects:

A
  • N/V/D

- dyspepsia

24
Q

Lanthanum (Fosrenol) drug interactions

A

give other medications 2hrs before or after

25
Q

Lanthanum (fosrenol) patient counseling:

A
  • chew tab before swallowing

- can cause N/V, and abdominal pain

26
Q

Patient counseling for Sucroferric oxyhydroxide (Velphoro):

A
  • chew before swallowing
  • lowest pill burden (3pills/day)
  • can cause diarrhea or darkening of stools
27
Q

Benefits of auryxia (Ferric citrate)

A
  • for use in dialysis patients only
  • increases TSAT & serum ferritin
  • may reduce EPO & IV dose needed
28
Q

Drug interactions of Paricalcitol

A
  • levels are increaed by strong 3A4 inhibitors (-azoles, -avirs, clarithromycin)
29
Q

Cinacalcet (Sensipar)

A
  • Do not start if serum Ca < 8.4mg/dL
  • If serum Ca falls below 8.4mg/dL, but greater than 7.5mg/dL (or symptomatic) then consider adding/increasing dose of Ca phosphate binders or Vit D
  • if serum Ca < 7.5mg/dL or adding/increasing of Ca phosphate binders or vit D not possible or still symptomatic then d/c cinacalcet

Therapeutics (19 decks)

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