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39 Cards in this Set
- Front
- Back
- 3rd side (hint)
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How many nephrons in one kidney? |
More than 1 million |
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Can Drugs bound to proteins go through glomerular pores? |
No, they're too big, unless there is damage to the kidney. |
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Name 3 substances reabsorbed in the kidneys. |
Water, Na, Chloride, Ca, bicarbonate. |
One is water, one is found in milk, two you can bake with, and one sounds like something found in most swimming pools. |
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Define Renal Failure |
Decrease in kidneys ability to maintain fluid balance, electrolyte balance, and to excrete waste products. |
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What is the basic diagnostic for renal failure? |
Urinalysis |
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What does a urinalysis measure for? |
The presence of blood cells, proteins, pH, specific gravity, ketones, glucose, and micro organisms. |
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Name two drug related interventions for patients in renal failure |
Discontinue nephrotoxic drugs Reduce drug doses |
They relate to the fact that the patient probably has impaired drug excretion due to the damage of their kidneys. |
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What are some indications for diuretics? |
HTN, ❤️ failure, and conditions characterized by build up of edema fluid. |
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What do diuretics do? |
Increase urine flow. |
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What is the primary mechanism of action for diuretics? |
Block Na reabsorption. |
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What are the 4 Diuretic Classifications? |
Loop Diuretics Thiazides Potassium Sparing Miscellaneous |
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Name 3 nephrotoxic drugs or classes of drugs |
Aminoglycosides Amphotericin ACE Inhibitors Cisplatin Cyclosporine Foscarnet NSAIDS Pentamidine Radio graphic IV contrast agents |
Table in pg345 |
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What is the most frequent cause of acute renal failure? |
Hypoperfusion |
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What is best market for measuring kidney function? |
GFR |
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Name 2 single tablet diuretic combinations |
Accuretic: hydrochlorothiazide, and quinapril Aldactazide: hydrochlorothiazide, and spirinolactone Apresazide: hydrochlorothiazide and hydralazine Tribenzor: Hydrochlorothiazide, olmesartan, and amlodipine Zestoretic: hydrochlorothiazide and lisinopril. |
They all contain hydrochlorothiazide |
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What are the most effective type of diuretics? |
Loop Diuretics |
They affect the loop of henle |
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What are the most effective type of diuretics? |
Loop Diuretics |
They affect the loop of henle |
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What is the most frequently prescribed loop diuretic? |
Furosemide |
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Name 4 loop Diuretics |
Bumetanide, ethacrynic acid, furosemide, torsemide |
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What is a main benefit of using torsemide? |
It has a longer half life allowing for once a day dosing. |
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How much more potent is bumetanide than furosemide? |
40x but it's short lived |
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Side and adverse effects of Loop Diuretics |
Minor hypoalkemia, postural hypotension, tinnitus, nausea, diarrhea, dizziness, fatigue
Significant hypoalkemia, blood dyscrasias, dehydration, ototoxicity, electrolyte imbalances, circulatory collapse |
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What is a concern when using a loop diuretic on a patient currently using digoxcin? |
Excess potassium loss can cause dysrhythmias. |
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Loop Diuretics are reserved for when? |
Patients with moderate to severe fluid retention, or when other Diuretics don't produce desired effects. |
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What is the most frequently prescribed class of diuretics. |
Thiazide |
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Where in the kidneys do thiazides block Na absorption? |
The distal tubule. |
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When are thiazides ineffective? |
In patients with severe renal failure. |
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When are thiazides ineffective? |
In patients with severe renal failure. |
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What teaching should be provided to patients with DM about thiazides? |
That they can raise blood glucose. |
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Side and adverse effects of thiazides. |
minor hypokalemia, fatigue
Significant hypoalkemia, electrolyte depletion, dehydration, hypotension, hyponatremia, hyperglycemia, coma, blood dycrasias |
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Name 1 short acting, intermediate acting, and long acting thiazide |
SA- chlorothiazide, hydrochlorothiazide
IA-bendroflumethiazude, metolazone
LA- chlorthalidone, indapimide, methyclothiazide |
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What is one of the most serious side effects of thiazides and loop Diuretics? |
Hypokalemia (low potassium) |
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What is the main benefit of potassium sparing Diuretics. |
Increases diuresis w/o affecting blood K+ |
It's in the name. |
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Name 3 potassium sparing Diuretics. |
Amiloride, eplerenone, spironolactone, triamterene |
Pg 349 |
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Side and adverse effects of potassium sparing Diuretics |
Minor hyperkalemia, headache, fatigue, gynecomastia (spironolactone)
Dysthymia, dehydration, hyponatremia, agranulocytosis and other blood dyscrasias |
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Name 1 carbonic anhydrayse inhibitor, and one osmotic diuretic. |
CAI- acetazolamide, methazolamide
Osmotic diuretics- glycerin, mannitol |
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Name 1 carbonic anhydrayse inhibitor, and one osmotic diuretic. |
CAI- acetazolamide, methazolamide
Osmotic diuretics- glycerin, mannitol |
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Why aren't carbonic anhydrayse Inhibitors usually used for diuresis? |
Produce weak diuresis, and metabolic acidosis |
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How is mannitol administered? |
IV only |
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