Mmc Pharmacology - Treatment Of Renal Disorders

Front 1

Treatment strategy for asymptomatic UTI

Back 1

1) Drink several glasses of water a day

2) Drink cranberry juice (or eat dried cranberries or raisins) daily

Note: Women should be advised to wipe from front to back after having a bowel movement

Front 2

Antibiotics commonly used to treat uncomplicated UTI

Back 2

1) trimethoprim-sulfamethoxizole (TMP/SMX)

2) Fluoroquinolone

3) Third generation cephalosporin (cefixime)

4) Nitrofurantoin

5) Amoxicillin/clavulanic acid

Front 3

Drugs used to treat complicated UTI

Back 3

1) Penicillin and gentamycin

2) Cefepime (4th generation cephalosporin)

3) Imipenem + Cilastatin (a dehydropeptidase inhibitor)

4) Meropenem

5) Piperacillin- tazobactam

6) Ticarcillin-clavulanate

NOTE:

If patient is allergic to penicillin, give them vancomycin instead

Front 4

Drugs that can be used to treat UTI in children

Back 4

After 2 months old:

trimethoprim-sulfamethoxizole

Other options include:

a) amoxicillin (first line in infants <2 month old)

b) cephalosporins such as cefixime

Front 5

Antibiotics used to treat gonococcal infections

Back 5

1) Cephalosporins (cefixime, ceftriaxone)

2) Fluoroquinolones (ciprofloxacin, ofloxacin)

3) Azithromycin

4) Doxycycline

Front 6

Antibiotics used to treat non-gonococcal infections

Back 6

1) Azithromycin

2) Doxcycline

3) Metronidazole

4) Erythromycin

NOTE: Penicillins will NOT work for these patients!

Front 7

Treatment strategy for epididymitis

Back 7

1) Use ceftriaxone or doxycycline if caused by gonococcal or chlamydial infection

2) Use ofloxacin if due to enteric infection

3) Hospitalization and parenteral antibiotics required if patient has sepsis or severe infection

Front 8

Treatment strategy for vesical candidiasis

Back 8

1) Use sodium bicarbonate to alkalinize urine

2) Give amphotericin B via catheterization three times a day

Front 9

Treatment strategy for candidiasis with renal involvement

Back 9

Irrigate renal pelvis with amphotericin B

Front 10

Treatment options for candidiasis with systemic involvement/candidemia

Back 10

1) Flucytosine (Ancobon)- DRUG OF CHOICE

2) Nifuratel (nitrofuran antibiotic)

3) Ketoconazole

4) Amphotericin B

Front 11

Treatment strategy for localized renal cell carcinoma

Back 11

1) In patients with smaller lesions, the primary choice is laparoscopic nephrectomy

2) A partial nephrectomy can be done in selected patients

3) If surgery is not feasible, cryotherapy and radiofrequency are options

Front 12

Treatment options for patients with advanced renal cell carcinoma

Back 12

1) Palliative surgery

2) Radiation therapy

3) Immunotherapy

4) Molecular-targeted therapy

5) Chemotherapy

Front 13

Radiation therapy for patients with advanced renal cell carcinoma (RCC)

Back 13

1) Effective in the palliation of symptomatic metatastatic RCC

2) Also effective in halting progression of RCC

3) Can be given alone or in combination with surgery

Front 14

Chemotherapy in patients with advanced renal cell carcinoma (RCC)

Back 14

1) RCC relatively resistant to chemotherapy

2) Temsirolimus (mTOR inhibitor) has been shown to increase patient survival

Note: There are ongoing clinical trials testing effects of combination chemotherapy (gemcitabine + 5-FU or carboplatin/cisplatin + gemcitabine)

Front 15

Interferon alfa

Back 15

1) Consists of a mixture of proteins with the functional properties of natural interferon alpha

2) An immunomodulatory cytokine that is used to treat renal cell carcinomas in combination with chemotherapy and radiation

Front 16

Interleukin 2

Back 16

A cytokine that activates the immune response against renal cell carcinomas; induces tumor remission at a rate of 10-20%

Front 17

Interferon alfa -

Side Effects

Back 17

1) Difficult/labored breathing or tightness in the chest

2) Swelling or puffiness of the face

Front 18

Interleukin 2 -

Side Effects

Back 18

1) Hypotension

2) Capillary leak syndrome

3) Myocardial infarction

4) Renal insufficiency

5) Pulmonary edema

6) Hepatic dysfunction

7) CNS dysfunction

Note: This treatment requires ICU monitoring

Front 19

Bevacizumab

Back 19

A recombinant monoclonal antibody that functions as an inhibitor of VEGF

Front 20

Sunitinib

Back 20

1) A small molecule that inhibits VEGF receptor (VEGFR); serves as a treatment for advanced renal cell carcinoma

2) Side effects include skin rash, hand-foot syndrome and cardiac dysfunction

Front 21

Sorafenib

Back 21

1) A small molecule inhibitor of VEGF receptor (VEGFR); used to treat advanced renal cell carcinoma

2) Side effects include skin rash and hand-foot syndrome

Front 22

Effects of NSAIDs on the kidney

Back 22

1) All nonselective NSAIDs (aspirin, ibuprofen and naproxen) and COX-2 inhibitors (celecoxib) reduce prostaglandin production and lower renal blood flow

2) This produces kidney injury that can result in renal failure, renal tubular necrosis and interstitial nephritis

3) As a result, renal function must be monitored in patients with renal disorders that are also taking NSAIDS

Front 23

Patients with renal disorders who should NOT take NSAIDs

Back 23

1) Patients with reduced kidney function

2) Patients on dialysis

3) Patients who've had kidney transplant

4) Long term self medication

Front 24

Nitrofurantoin- Mechanism of Action

Back 24

Antibacterial agent that is converted to reactive intermediates that disrupt DNA, RNA and protein synthesis and inhibit bacterial enzyme systems