The kidney and drugs

Question 1

xenobiotics=

Answer 1

a chemical compound foreign to a given biological system

Question 2

pH of kidney

Answer 2

5-7

Question 3

clearance=

Answer 3

rate at which substance is removed from the blood

Question 4

if something is uncharged how does this affect reabsorption from the kidney tubule

Answer 4

charged reabsorbed more quickly (so cleared slowly)

Question 5

what does a tablet have to go through before entering the blood system

Answer 5

first pass mechanism through liver

Question 6

what diet is more alkaline

Answer 6

fruit and vegetable

Question 7

what diet is more acidic

Answer 7

more protein based

Question 8

2 things concentration of drug in urine is determined by

Answer 8

• entrance of the drug into tubular fluid

- reabsorption from tubular fluid

Question 9

what happens to ionized drugs in the tubule

Answer 9

they stay there

Question 10

what happens to lipid soluble drugs in the tubule

Answer 10

almost completely reabsorbed

Question 11

clearance of acidic drug=

Answer 11

slower

Question 12

clearance of alkaline drug=

Answer 12

faster

Question 13

half life (T1/2) =

Answer 13

the time needed to halve plasma conc of drug

Question 14

half life is dependant on (2)

Answer 14

volume of distribution

clearance

Question 15

what can aminoglycosides and loop diuretics cause in renal failure

Answer 15

otoxicity

Question 16

what happens to drugs in renal failure

Answer 16

clearance is reduced so they build up in the body

Question 17

4 drugs affecting the PCT directly

Answer 17

• aminoglycosides
• cisplatin
• immunoglobulins
• mannitol

Question 18

4 drugs affecting the DCT directly

Answer 18

• NSAIDs
• ACE inhibitors
• Ciclosporin
• cyclophosphamide

Question 19

e.g of osmotic diuretic

Answer 19

mannitol

Question 20

where do osmotic diuretics work

Answer 20

proximal convoluted tubule

Question 21

when to use osmotic diuretics (3)

Answer 21

prior to neurosurgery
early cerebral oedema
reduce intraocular pressure

Question 22

where do carbonic anhydrase inhibitors work

Answer 22

proximal tubule

Question 23

MOA of carbonic anhydrase inhibitors

Answer 23

target H+/Na+ exchange so Na+ stays in filtrate and more H2O

Question 24

e.g of carbonic anhydrase

Answer 24

Actazolamide

Question 25

what do loop diuretics act on

Answer 25

Na+/K+/2Cl- co-transporter on Cl- binding site

Question 26

e.g loop diuretic

Answer 26

furosemide

Question 27

when are loop diuretics used

Answer 27

• pulmonary oedema from LV failure

- chronic heart failure

Question 28

what drugs work on the DCT

Answer 28

thiazides

Question 29

what do thiazides target

Answer 29

Na/Cl/K co-transporter

Question 30

what do you lose lots from thiazides (and need to give supplements for)

Answer 30

Potassium

Question 31

what is the dose like for thiazides

Answer 31

low

Question 32

aldosterone antagonist (MR- antagonist)

Answer 32

spironolactone

Question 33

what does spironolactone spare

Answer 33

potassium

Question 34

2 drugs causing tubular toxicity

Answer 34

aminoglycosides

tetracyclines

Question 35

NSAIDs effect on afferent arteriole=

Answer 35

vasoconstriction

Question 36

what 2 drugs need intense hydration when taking

Answer 36

methotrexate

cisplatin

Question 37

what drugs cause glomerulopathy

Answer 37

NSAIDs