NR 508 Week-8 Final Exam Guide

NR 508 Week-8 Final Exam Guide

NR 508 Week-8 Final Exam Guide

NR 508 Advanced Pharmacology

Cardiovascular management:

Know Initial treatment choices for HTN

Ace inhibitors and ARBs

Know first line treatment options for HTN for African Americans without renal impairment.

Thiazides

First line option for HTN for anyone with chronic kidney disease

ACEIs or ARBs, appropriate diuretic therapy, and dietary salt restriction make up the foundation for the treatment of HTN in CKD.  Lisinapril  and Furosomide.

IN most instances, the hypertensive CKD patient requires multiple drugs to reach goal blood pressure. Multiple antihypertensive drug combinations are possible in the CKD patient. One combination of note is that of an agent that blocks the effects of the renin-angiotensin system given together with a loop diuretic and any of several other drug classes.

Diuretics: types, uses side effects, names; preferred diuretic with renal impairment; side effect of post diuretic sodium retention; recognition that some diuretics are sulfa derivatives (carbonic anhydrase inhibitors, loop diuretics, thiazides, but NOT ethacrynic acid); management of edema

Thiazide diuretics increases amount of urine produced by reducing sodium re-absorbtion in the kidney. Another effect they have is to widen the blood vessels which also helps reduce blood pressure.

bendroflumethiazide ,  chlorothiazide, chlorthalidone,  hydrochlorothiazide,  indapamide,  metolazone.

Loop diuretics are powerful diuretics that work in a part of the kidney called the loop of Henle where they reduce sodium, chloride and potassium reabsorption. This increases the amount of urine produced which helps reduce blood pressure and also helps remove any extra fluid that has been accumulating around the body (odema) or the lungs.

Furosemide (Lasix), Bumetanide (Bumex), Torsemide (Demadex), Chlorothiazide (Diuril)

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Potassium sparing diuretics are weaker diuretics that have their effect by increasing the amount of water and sodium that passes through the kidneys to increase urine volume. Because there is no increase in the amount of potassium that is passed through the kidney sometimes you may end up with higher potassium levels. Examples are

Eplerenone (Inspra), Triamterene (Dyrenium), Spironolactone (Aldactone), Amiloride (Midamorgeneric), Spironolactone(CaroSpir)

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Carbonic anhydrase inhibitors are weaker diuretics that act by increasing the amount bicarbonate, sodium, potassium and water excreted from the kidney. Carbonic anhydrase inhibitors are also used to reduce fluid levels in the eye and is sometimes used off-label for altitude sickness. An example is Acetazolamide ………………………… document continue