Renal/liver/thyroid

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Author:
kmegk22
ID:
154935
Filename:
Renal/liver/thyroid
Updated:
2012-05-20 19:22:26
Tags:
renal
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Description:
renal
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  1. S/S dehydration
    • Bun:Scr
    • weakness, dec urine, tachycardia
  2. thiazide MOA
    • inhibib Na Cl pump on proximal loop
    • -protective of ca
    • -weaker than k sparring
  3. loop MOA
    • inhib Na K pump on ascending loop
    • -less Na reabsorbed, also less ca over time - osteoprosis
  4. inc in aldosterone -->
    inc Na and H20 renention
  5. sprinolactione MOA
    decreases aldosterone, dec- NA and water retention
  6. Scr
    0.6-1.2mg/dl
  7. metoclopramide in the elderly
    dopamine blocker
  8. tx of protenuria
    • ace-- efferent arterioloar dilation
    • control BP, glucose
  9. CKD- anemia
    iron, folate, b12
  10. CKD- bone
    • inc in phos: use phosphate binders
    • dec vit D: compensation for phos: suppement
    • inc K: monitor
  11. phosphate binders
    • 1. aluminum: Al tox - altenosa, emphage
    • 2. calcium: hypercalceimia, Phoslo, Tums
    • 3. neither: forselo, renegel
  12. normal K
    3.5-5
  13. metabolic acidosis tx
    sodium bicarb, b agonist, ben albuterol, kayexolate
  14. s/s liver dysfunction
    NV loss app, dia, malaise, ab pain, jaundice
  15. ALT
    7-55
  16. AST
    10-40
  17. albumin
    3.5-5.5
  18. hep B treatment
    • 1. interferons
    • 2. NRTI
  19. interferon 2 alpha
    • PEG- pegasys, peg iner- extends to weekly administration
    • BBW: autoimmune dx, psychiatrics, depression, suicide
    • se: flu-like, neutropenia, thrombo, pneumitis, pancreatitis, myalgia, arrhythmia, inc LFT,
  20. NRTI for hep b SE
    • BBW: lactic acidosis, helpatomegali
    • ha, fatigue, nv, diarr, inc LFT,
  21. NRTI for hep b names
    • lamivudine- epivir
    • adefovir- hepersa (CI renal)
    • tenofovir (viread)- fanconi, renal, bone
    • entiecavir (barcalude)
    • telbuvdine (tyzeka)- myopathy
  22. hep C tx
    ribavarin + interferon + PI
  23. ribavarin
    • MOA: inhibits replication
    • ci: crcl<50
    • BBW: preggers
    • SE: hemolytic anemia, cv dx
    • di: inc NRTI
  24. PI for hep c
    • boceperevir (victrelis)
    • se: fatigue, anemia, neutropenia, - NEVER MONOTHERAPY

    • telapravir (incevek)
    • se: rash

    no preggers
  25. hypo
    dec t4 --> inc TSH
  26. hyper
    inc t4 --> dec TSH
  27. t4
    0.8-1.7mcg.dl
  28. TSH
    0.3-3mcg/ml
  29. hypo causes
    • hashmoto
    • lithium, amiodarone, interferon
  30. treatments for hypo
    • levothyroxine - t4
    • thyroid USP- armout thyroid- t3and t4
    • liothyronine- t3- cytomel- shorter t1/2
    • liotrix- t3 and t4
  31. levothyroxine
    • BBW: euthyroid pts
    • se: inc HR, palpitaions, sweating, wt loss, arrthymias
    • CI- MI, adrenal insuff
    • M: w 6-8weks
  32. hyper causes
    • graves
    • idodinem amiodarone, interferon
  33. hyper tx
    • radioactive iodine
    • PTU
    • Methmiazole
    • iodines
  34. thionamides MOA
    inhibit synthesis of thyroid hormones by blocking oxidation of idonide in gland
  35. PTU - propylthiouracil
    methimazole
    • PTU also blocks t4 to t3
    • BBW: liver
    • SE: gi upset, hepatitis, agranulocytosis

    TAKE WITH FOOD
  36. THYROID STORM
    • caused by stress
    • s/s: fever of 103, tachycardia, sweating, agitiation
    • tx: PTU 900-1200 divied q 4h + SSKI q 8h + propranolol q 6h + dex q 6 h

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