Renal Drug List

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jknell
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128693
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Renal Drug List
Updated:
2012-01-18 13:55:47
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Renal drug list
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Renal Drug List
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  1. Carbonic Anhydrase Inhibitors
    Acetazolamide
  2. Acetazolamide
    Mechanism: inhibits CA leading to decreased H+ secretion in PT (via NHE) causing decreased rebasorption of Na+ and HCO3-

    Indications: glaucoma, acute mountain sickness

    Adverse Effects: Hypokalemia, Metabolic acidosis, nephrolithiasis

    Other: max decreased Na+ reabsorption = 5%
  3. Loop Diuretics
    • Furosemide (Lasix)
    • Bumetanide (Blimex)
  4. Furosemide (Lasix)
    Mechanism: Inhibit NKCC2 --> decreased reabsorption of Na+ and Cl- in thick AL

    Indications: Edema, HTN, Acute hypercalcemia

    Adverse Effects: Hypokalemia, metabolic alkalosis, hypocalcemia, hypomagnesemia, hyperuricemia, hyponatremia, hypovolemia, postural hypotension, hyperglycemia, hyperlipidemia, ototoxicity (tinnitus)

    Other: maximum decreased Na+ reabsorption 25-30%, 'high ceiling diuretics'
  5. Bumetanide (Blimex)
    Mechanism: Inhibit NKCC2 --> decreased reabsorption of Na+ and Cl- in thick AL

    Indications: Edema, HTN, Acute hypercalcemia

    • Adverse Effects: Hypokalemia, metabolic alkalosis, hypocalcemia,
    • hypomagnesemia, hyperuricemia, hyponatremia, hypovolemia, postural
    • hypotension, hyperglycemia, hyperlipidemia, ototoxicity (tinnitus)

    Other: maximum decreased Na+ reabsorption 25-30%, 'high ceiling diuretics'
  6. Thiazide Diuretics
    • Hydrochlorothiazide
    • Chlorothalidone
  7. Hydrochlorothiazide
    Mechanism: inhibit NCC --> decreased reabsorption of Na+, Cl- in DCT

    Indications: HTN, edema, Nephrolithiasis due to idiopathic hypercalciuria, nephrogenic diabetes insipidus

    Adverse Effects: hypokalemia, metabolic alkalosis, hypercalcemia, hypomagnesemia, hypouricemia, hyponatremia, hypovolemia, postural hypotension, hyperglycemia, hyperlipidemia

    Other: max decrease in Na+ reabsorption 5-8%
  8. Chlorthalidone
    • Mechanism: inhibit NCC --> decreased reabsorption of Na+, Cl- in DCTIndications: HTN, edema, Nephrolithiasis due to idiopathic hypercalciuria, nephrogenic diabetes insipidusAdverse
    • Effects: hypokalemia, metabolic alkalosis, hypercalcemia,
    • hypomagnesemia, hypouricemia, hyponatremia, hypovolemia, postural
    • hypotension, hyperglycemia, hyperlipidemiaOther: max decrease in Na+ reabsorption 5-8%
  9. K+ Sparing Diuretics
    • Amiloride
    • Triamterene
    • Spironolactone
  10. Amiloride
    Mechanism: block ENaC --> decreased reabosrption of Na+ in CD

    Indications: Edema, HTN, primary/secondary hyperaldosteronism

    Adverse Effects: Hyperkalemia, Metabolic acidosis, spironolactone: endocrine side effects

    Other: Max decrease in Na+ reabsorption 1-2%, most commonly used in combination therapy, alone usually used for hyperaldosteronism
  11. Triamterene
    Mechanism: block ENaC --> decreased reabosrption of Na+ in CD

    Indications: Edema, HTN, primary/secondary hyperaldosteronism

    Adverse Effects: Hyperkalemia, Metabolic acidosis, spironolactone: endocrine side effects

    • Other: Max decrease in Na+ reabsorption 1-2%, most commonly used in
    • combination therapy, alone usually used for hyperaldosteronism
  12. Spironolactone
    Mechanism: inhibit binding of aldosterone to cytoplasmic minearlocorticoid receptor --> decreased reabosorption of Na+ in CD via ENaC

    Indications: Edema, HTN, primary/secondary hyperaldosteronism

    Adverse Effects: Hyperkalemia, Metabolic acidosis, spironolactone: endocrine side effects

    • Other: Max decrease in Na+ reabsorption 1-2%, most commonly used in
    • combination therapy, alone usually used for hyperaldosteronism
  13. Osmotic Diuretics
    Mannitol
  14. Mannitol
    Mechanism: inhibit reabsorption of Na+, other solutes by a physiological mechanism (mainly involving PT)

    Indications: rapid induction of large natiuresis and diuresis, shift of fluid from IC to EC (cerebral edema, dialysis disequilibrium syndrome, crush injuries, glaucoma)

    Adverse Effects: pulmonary edema in pts with decreased LV function

    Other: max decrease Na+ reabosrption 20%
  15. Aquaretics
    • Conivaptan
    • Tolvaptan
    • Demeclocycline
  16. Conivaptan
    Mechansim: block V2 receptors

    Indications: hyponatremia (due to SIADH)

    Adverse Effects: Hypernatremia, Dehydration

    Other: Conivaptan only approved for short term IV use, Tolvaptan given orally but should be initiated in hospital)
  17. Tolvaptan
    Mechansim: block V2 receptors

    Indications: hyponatremia (due to SIADH)

    Adverse Effects: Hypernatremia, Dehydration

    Other: Conivaptan only approved for short term IV use, Tolvaptan given orally but should be initiated in hospital)
  18. Demeclocycline
    Mechanism: decrease responsiveness of CD to ADH

    Indications: Hyponatremia (due to SIADH)

    Adverse Effects: Hypernatremia, Dehydration, nausea, vomiting, photosensitivity, Lithium (neuropsychiatric side effects, weight gain)

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