Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

2514 Patho/phys/assess > Week 10 CKD Kidney pharm > Flashcards

Week 10 CKD Kidney pharm Flashcards

1
Q

How does medication slow progression of CKD?

A
  1. reduce damage to the kidney
  2. manage the consequences of reduced GFR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 ways we reduce damage to the kidney in CKD?

A

1 Lower BP
2. control atherosclerosis
3. control blood sugar (DM)

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

What stage is reducing damage to the kidneys in CKD?

A

stage 3

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

What 3 ways do we manage the physical consequences of reduced GFR?

A
  1. diuretics for fluid overload
  2. rebalance electrolyte imbalances (Na+ K+ Cal phos)
  3. check hormone imbalance (epo) & give endogenous (blood transfusion) epo where needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the CKD meds?

A
  1. Captopril
  2. Candesartan
  3. Atorvastatin (Lipitor)
  4. Furosimide
  5. Hydrochlorothiazide
  6. Spironolactone
  7. Ethropoeitin
  8. Calcium carbonate
  9. Sodium Polystyrene Sulfonate (Kayexalate)
  10. Ferrous Sulfate (Feosol)
  11. Calcitriol (Rocaltrol)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What drug class is captropril and why is it used?

A

ACE inhibitor
to stop angiotensin 1 converting to angiotensin II - RAAS so that Na+ will stop absorbing and stop fluid retention

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

What alternative is used if the cough from captopril can’t be tolerated?

A

candesartan

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

What does captopril do for the glomerulus?

A

stops afferent arteriole pressure
dilates efferent arteriole

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

What is captopril contraindicated in?

A
  1. pregnancy
  2. breastfeeding
  3. renal artery stenosis
  4. angioedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 3 adverse effects of captopril?

A
  1. first dose hypotension
  2. cough
  3. hyperkalemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What should nurses monitor with people on captopril?

A
  1. BP - esp first dose and changes
  2. fluid volume/dehydration
  3. blood work - K+, Na+, Urea, creatinine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If blood pressure drops do we have hyperperfusion to the kidneys or hypoperfusion ?

A

hypoperfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the drug class of candesartan and what does it do?

A

ARB
angiotensin II receptor blocker
blocks angiotensin 2 from reaching the receptor on the adrenal cortex

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

are the contraindications of candesartan and captopril the same?

A

yes

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

Do ARBs or ACE inhibitors decrease cardiovascular morbitidy?

A

ACE inhibitors

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

Which medication causes cough?

A

Captopril

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

What should we always monitor for patients on atorvastatin?

A

LFTs
CK (creatine kinase - when there is muscle cell damage is releases this enzyme)

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

How long does it take to see the effects of Atorvastatin?

A

2 weeks

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

where does Furosemide work?

A

on the ascending limb (the fat part) of the loop of Henle

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

When GFR is low can we still use a diuretic?

A

yes! this is an advantage!

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

What is furosemide contraindicated in?

A
  1. someone who has no urine output - anuria <40ml
  2. hepatic coma - a coma from liver issues - can cause cerebra edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the adverse effects of Furosemide?

A
  1. Hyponatremia
  2. Hypocholremia
  3. Dehydration
  4. hypotension
  5. hypokalemia
  6. Ototoxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a unique side effect to furosemide not seen in other diuretics?

A

ototoxicity - reversed when meds stop

24
Q

what is the MOA of hydrochlorothiazide?

A

Blocks Na and Cl in early segment of the distal convoluted tubule
the top fat part

25
What GFR rate is hydrochlorothiazide ineffective?
<15-20ml/min
26
Hydrochlorothiazide and furosomide make all the electrolytes hypo or hyper?
Hypo
27
What does Spironolactone work on in the nephron?
Blocks the action of aldosterone in the distal nephron the last straight tube
28
Does spironolactone keep K+ or excrete K+?
Keep it so that not too much is lost
29
what is spironolactone contraindicated in?
1. no pee - anuria 2. Addison’s disease – don’t block what aldosterone they do have b/c blocking it can cause hyponatremia and hyperkalemia 3. severe renal disease (GFR<30 ml/min) 4. if they are already hyperkalemic 5. pregnancy, breastfeeding
30
what GFR rate is spironolactone no longer effective?
<30 ml/min
31
what part of the nephron does aldosterone take effect and which diuretic interferes with this?
in the late distal convoluted tubule/collecting duct spironolactone messes with aldosterone here
32
Why does spironolactone have endocrine effects?
it's a steroid derivative so connected to the adrenal gland which is responsible for sex hormone secretion
33
What are the adverse effects of spironolactone?
1. hyperkalemia 2. endocrine effect
34
What are the 2 endocrine effects of spironolactone on males and the 2 affects on females?
male: impotence gynecomastia female: irregular mestral cycle hirsutism - facial hair
35
what isErythropoietin (Epogen)?
a glycoprotein hormone that stimulates RBC production in bone marrow
36
what do we want to see with Hgb when someone is on EPO?
*lower* Hgb than what is normal due to blood viscosity 100-120g/L
37
What are the adverse effects of EPO?
hypertension HTN due to increased blood viscosity MI and stroke is Hgb is too high
38
when do we not give epo?
when someone's HTN is uncontrolled
39
When does epo start working?
2-3 weeks
40
when does epo peak?
2-3 months
41
what is the MOA of calcium carbonate?
Binds to phosphate in GI tract and is excreted in stool
42
What brand name is calcium carbonate known by?
Tums
43
What is the drug class of calcium carbonate?
Calcium-Based Phosphate Binder
44
Why do we give calcium carbonate?
help reduce too much phosphate in the blood. Calcium binds to phosphate and gets excreted in the stool
45
what is calcium carbonate contraindicated in?
1. hypercalcemia 2. severe cardiac disease
46
What are the 4 adverse effects of calcium carbonate?
1. constipation 2. GI irritation 3. renal calculi (kidney stones) 4. dig toxicity - check heart
47
how long after a meal should calcium carbonate be given and why?
1 hours after meal to bind with ingested phosphate from food
48
What drug class is Sodium Polystyrene Sulfonate (Kayexalate) ?
potassium binding agent to get rid of excess potassium
49
What is the MOA of Sodium polysyrene sulfonate (kayexalate)?
a resin removes potassium by exchanging it with sodium in large intestine The resin gives sodium and takes on potassium to be excreted
50
When is Sodium polysyrene sulfonate (kayexalate) contraindicated?
GI obstruction or even suspected obstruction
51
What are the adverse effects of Sodium polysyrene sulfonate (kayexalate)?
- GI issues (N&V, constipation, dehydration) - Dig toxicity
52
What is the MOA of Ferrous Sulfate (Feosol)?
make more iron iron is a part of a red blood cell. If lacking iron then RBC can't be made. If RBC can't be made then you can't carry o2 around the body or get rid of Co2. If you can't make enough RBC then you have anemia
53
What is the drug class of Calcitriol (Rocaltrol)?
activated vitamin D hormone suppliment
54
what is the MOA of Calcitriol (Rocaltrol)
helps absorb more calcium in the intestine
55
What disease does Calcitriol (Roclatrol) help prevent?
osteodystrophy - when bones don't develop right because CKD hurts vitamin D production from the kidney so calcium is not properly absorbed for bone formation hypocalcemia w/ CKD

2514 Patho/phys/assess (27 decks)

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