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59 Cards in this Set

  • Front
  • Back
Mannitol is an
IV osmotic diuretic
spironolactone is a
K sparing diuretic and also
aldosterone antagonist
no great boost to loops, but often combined with a loop in stage C CHF
amiloride
a K sparing diuretic
This patient may have suffered from ethanol induced central DI – he has lost fluid, not sodium. He is not symptomatic so USe
dextrose 5% is best.
Loss of fluid and acedemia, give
Lactated Ringers - isotonic
DDAVP is a
vasopressin or ADH analog – it will cause increased resorption of water, with minimal effect on K.
trimethoprim (a component of sulfamethoxazole/trimethoprim or Septra) can block
Na+ resorption in the collecting duct, leading to retention of K (acts like a K sparing diuretic);
triamterene is a
K sparing diuretic.
eplerenone
As an aldosterone antagonist, will increase K retention.
The carbonic anhydrase inhibitors (e.g., acetazolamide) increase
renal secretion of bicarb and increase systemic retention of H+, causing a mild metabolic acidosis
Lithium can cause
nephrogenic diabetes insipidus
albuterol can cause
cause hypokalemia by shifting K+ intracellularly (not a renal mechanism)
amiloride
is a K+ sparing diuretic.
Albuterol and other beta2 agonists will cause a
shift of K+ intracellularly due in part to increased glucose uptake by skeletal muscle.
Calcium chloride does NOT (K)
reduce serum K, nor does it reduce total body K, but it antagonizes the effects of hyperkalemia.
Furosemide increases (K)
renal K losses
sodium polystyrene sulfonate (SPS or Kayexelate) is a
a K binding resin that binds to K in the gut and increases fecal losses of K – a slower route for reducing K but an effective one
Which other drugs cause an intracellular K shift?
Bicarb, insulin + glucose shift K
Beta 2 agonist
ACEI (or ARB) are indicated in
diabetic patients with microalbuminurea to spare the kidneys.
Patients with diminished GFR are at risk for
hyperkalemia
N-acetylcysteine is effective for
radiocontrast induced nephropathy (bicarb is used also
Dihydroxy vitamin D3 (calcitriol) cause
hypercalcemia
Calcitriol promotes the absorption of
both Calcium from the gut, bone, and kidney
Cinacalcet is a ___ and cause__
a calcimimetic (not a D analog at all!) that more commonly will cause hypocalcemia
Lithium causes___ and TX
nephrogenic DI so Amiloride (with or without HCTZ )is the drug of choice to treat
that amiloride blocks Li uptake into cells, thereby restoring sensitivity to ADH
NSAIDs have been used to treat
lithium induced NDI
conaVAPtAN is a
VAsoPressin ANtagonist
demeclocycline
CAUSES NDI
DDAVP is used only for
central DI, where the problem is a lack of ADH, not loss of response to ADH
For men with incontinence related to BPH (overflow incontinence. TX?
alpha 1 antagonists are generally most effective
they are generally used if the patient has BPH and/or overflow combined with hypertension
doxazosin
is characterized by frequent urination due to increased bladder smooth muscle tone
urge incontinence in women
TX: antimuscarinics
Loop diuretics and Ca
Loop diuretics increase urinary calcium loss,
thiazides and Ca
thiazides (hydrochlorothiazide, metolazone) cause calcium retention.
Carbonic anhydrase inhibitors
inhibitors increase urinary calcium too, but aren’t very potent (therefore loop is the best answer)
Sevalemer is a
phosphate binder and give it with meals.
Ergocalciferol and paricalcitol are
D2 analogs which will increased calcium and phosphate absorption from the gut
Sodium polystyrene sulfonate is a
K binder, not a PO4 binder.
Which phosphate binders can reduce PO4, increase calcium, and address acidemia?
Calcium acetate and bicarb are used to address all 3, but calciphylaxis may occur
Milk of magnesia contains
Mg
Digoxin may accumulate
accumulate in renally impaired patients, but you’d be more likely to see nausea/vomiting, hyperkalemia disturbances of vision (yellow vision), and arrhythmia.


Since digoxin inhibits Na/K ATPase, in toxicity K accumulates extracellularly
Sodium polystyrene sulfonate is
cation binding resin that removes K from the gut
Furosemide is likely to cause
ototoxicity and dehydration (in patients who can’t access water)
What drug?

SE: false elevation of Screatine
SMX/TMP
SE?
SMX/TMP
SE: false elevation of Screatine
What drug?
HYperCa
HcTHZ

(SMX/TMP)
SE?
HcTHZ

(SMX/TMP)
HYperCa
What drug?
SE: HypoMg
furosemide
HCTHZ
Amphoteracin B
Gentamicin
radiocontrast
SE?
furosemide
HCTHZ
Amphoteracin B
Gentamicin
radiocontrast
Cause HypoMg
What drug?
SE; nephrolithiasis and obstructive nephropathy
Indinavir
SMX/TMP
SE?
Indinavir
SMX/TMP
SE; nephrolithiasis and obstructive nephropathy
What drug?
SE: Hypervolemic or euvolemic Hyponatremia
SIADH
Fluoxetine
DDAVP/desmopressin
SE?
Fluoxetine
DDAVP/desmopressin
SE: Hypervolemic or euvolemic Hyponatremia
What drug?
SE: ATN (intrinsic damage)
Amphoteracin B
Gentamicin
radiocontrast
SE?
Amphoteracin B
Gentamicin
radiocontrast
ATN (intrinsic damage)
What drug?
SE: Hypocalcemia
furosemide
cincacalcet
SE?
furosemide
cincacalcet
Hypocalcemia
What drug?
SE: NDI
Lithium
ethanol
demelocycline
SE?
Lithium
ethanol
demelocycline
NDI