Renal Therapeutics Flashcards
what things can we treat that are associated with renal disease?
proteinuria
hypertension
hyperphosphatemia
anemia
electrolytes: usually potassium
what can we use to block RAAS?
angiotensin converting enzyme inhibitors
angiotensin-receptor blockers
when do we use drugs to block RAAS?
proteinuria
CHF
hypertension
what do we do to monitor angiotensin converting enzyme inhibitors and angiotensin-receptor blockers?
monitor blood pressure and renal values
why is benazepril preferred in kidney disease over enalapril?
benazepril also has hepatic elimination so less potential for accumulation
how much of a drop in blood pressure can angiotensin converting enzyme inhibitors cause?
10-15% overall reduction
what is amlodipine?
calcium channel blocker
are angiotensin-receptor blockers useful for hypertension?
maybe
telmisartan approved for cats
what should you start if the PCV in a kidney disease animal is less that 20%?
generally recombinant human erythropoietin
what happens in 60% of cats on darbepoetin?
hypertension
what are some ways to increase appetite?
capromorelin
ghrelin agonist
mirtazapine
cerenia for nausea
how long do we need to treat leptospirosis with doxycycline?
2 weeks
what are good first choices for treating pyelonephritis?
fluoroquinolone
cefpodoxime
when should you reduce the dose of a drug for an animal with kidney disease?
drugs with >70% renal elimination
GFR is <66% of normal
drugs with narrow therapeutic range
what things can we use to treat renal disease?
diet
fluids
antimicrobials
surgery
dialysis
uncommonly diuretics
rarely anti-inflammatory/immunosuppression
what is an angiotensin-receptor blocker?
telmisartan
what are some angiotensin converting enzyme inhibitors?
enalapril
benazepril
what is the goal of ACE inhibitor and angiotensin receptor blocker therapy?
decrease UPC to <0.5 or 50% baseline
do angiotensin receptor blockers or ACE inhibitors have a greater decrease in GFR?
angiotensin receptor blockers: more concerning for already azotemic
what drugs can we use for hypertension?
ACE inhibitors
amlodipine
angiotensin receptor blockers
which angiotensin receptor blocker is approved for feline hypertension?
telmisartan: semintra
what is amlodipine?
calcium channel blocker
which drug is the first choice for cats with hypertension?
amlodipine
is darbopoeitin or epoetin alfa more immunogenic?
epoetin alfa more immuogenic
when should you start recominant human erythropoietin?
if PCV<20%
what should you give to a cat with chronic kidney disease and anemia (moderate)?
darbeepoietin
parenteral iron dextran
what are the adverse effects of darbepoietin?
hypertension
seizures
+/- vomiting, fever
pure red cell aplasia
what can you use to treat leptospirosis?
doxycycline for 2 weeks
ampicillin prior to if having gastrointestinal signs, then must follow with 2 weeks of doxycycline
what are some nephrotoxic drugs?
NSAIDs
aminoglycosides
how can we use creatinine to estimate GFR?
1/creatinine about proportional to GFR for creatinine<4mg/dL
why would we want to estimate GFR?
adjust doses of drugs in animals with kidney disease
what is the indication for aluminum hydroxide?
hyperphosphatemia insufficiently controlled by diet
