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TTC Ch. 11 Review
| Question | Answer |
|---|---|
| The primary function of __________ is to maintain the balance of water, electrolytes, and acids and bases in the extra-cellular fluid (plasma and tissue fluid) environment of the body | kidneys |
| They accomplish this function through the formation of _____________, which is the a modified filtrate of plasma | urine |
| In the process of urine formation, the kidneys regulate what 4 things? | 1) the volume of blood plasma and thus contribute to significantly to the regulation of blood pressure; 2) the concentration of waste products in the blood; 3) concentration of electrolytes in the plasma; 4)and the pH or acid base of plasma |
| The nephrons work in a highly consistent manner to produce what? | urine |
| The renal tubules of the nephrons produce urine through what three processes? | filtration, reabsorption, and secretion |
| The removal of substances from the blood, takes place in the glomeruli | filtration |
| During __________, filtered substances are selectively pulled back into the blood. | reabsorption |
| In the __________, sodium is absorbed with chloride | Loop of Henle |
| Hydrogen ion __________ regulates acid-base balance and acidification of urine. | secretion |
| Clinical syndrome resulting from renal dysfunction | uremia |
| In this stage of renal disease, patients are generally asymptomatic | Loss of Renal Reserve |
| In this stage of renal disease, patients are still asymptomatic, but may have nocturia secondary to a loss of urinary concentrating ability, hypertension second. to volume expansion from impaired sodium excetion or both. BUN level is mildly elevated. | Renal Insufficiency |
| In this stage of renal disease, patients are easily fatigued, and are intolerant of cold, and have abnormal taste sensation and anorexia. | Chronic Renal Insufficiency |
| Lab test for kidney function | creatinine clearance |
| In this stage of renal disease, the patient requires chronic dialysis | End-Stage Renal Disease (ESRD) |
| Blood fluid volume problems other than those caused by the kidney can be due to what? | diurectics, vomiting, nasogastric suction, diarrhea, hemorrhage, burns, adrenal insufficiency, or diabetic ketoacidosis |
| A decreased effective volume may be caused by what conditions? | CHF, MI, cirrhosis, sepsis, vasodilators, or pulmonary edema |
| Changes inside the kidney such as ________________ can all contribute to declining renal function. | rapidly progressive glomerulonephritis, renal vein thrombosis, vascular obstruction, vasculitis and hypertension |
| Kills or disables kidney cells | nephrotoxins |
| ___________ can cause the glomerular membrane to rupture, allowing filtrates and blood to work into the capsular space and stimulating fibrin formation. | Glomerular inflammation |
| The ______ and ________ can be damaged by crystals, clots, stones, tumor, fibrosis, infection, endometriosis, and papillary necrosis. | urethra and ureter |
| This condition can lead to renal failure | endometriosis |
| __________ can be serious, as in prostatic hyperplasia and cancer | bladder disease |
| A diagnosis of renal disease is made by what two indicators? | signs and evaluations |
| ______ include orthosatic blood pressure, skin turgor, temperature, color, edema, weight loss, changes in urine volume and bad urine odor | signs or renal disease |
| __________ include filtration rate, urine volume, electrolyte levels and osmolality, urine protein level, mesuring of other urine contents, serum creatinine level, and BUN | evaluations of renal disease |
| ________ is aimed at reestablishing and appropriate intravascular volume and pressure, restricting fluids in volume-overload cases, and treating the underlying problem | renal therapy |
| Fluids, sodium, potassium, calcium, and magnesium are all what? | electrolytes |
| Anemia due to renal failure is caused by decreased __________ | erythropoietin |
| This hormone, which is secreted by the kidneys, stimulates the production of red blood cells | erythropoietin |
| Patients undergoing hemodialysis or peritoneal dialysis may have a rise in _________ indicating that inhibiting substances are being removed by dialysis. | hematocrit |
| Proportion of red blood cells | hematocrit |
| Patients undergoing dialysis must also be watched closely for ______________, which interfers with the incorporation of iron into erythrocytes. | aluminum intoxication |
| Sucralfate and aluminum-containing antacids can be the cause of this | aluminum intoxication |
| If a patient is on dialysis, the pharm tech. must be away that the drugs must be dosed how? | differently, and also the dosing should always be checked |
| Drug for Renal Disease | cinacalcet, comes in a tablet |
| Used to treat anemia associated with end-stage renal disease | epoetin alfa, erythropoietin- Epogen, Procrit |
| Immature red blood cells | reticulocytes |
| Epogen, Procrit induces the release of __________ from bone marrow into the bloodstream, which eventually mature into erythrocytes. | reticulocytes |
| A longer-acting erythropoietin analog for anemia | darbepoetin alfa- Aranesp |
| Amino acid derative involved in metabolism; A cofactor needed for the transformation of long-chain fatty acids | levocarnitine- Carnitor |
| Lowers parathyroid hormone, calcium, and phosphate levels and is indicated for the treatment of secondary hyperparathyroidism in adult patients on dialysis | cinacalcet- Sensipar |
| An immunosuppressant used to prevent the body from rejecting a kidney transplant and is usually combined with cyclosporine and a steroid | mycophenolic acid- Myfortic |
| Has a local anesthetic effect on urinary tract mucosa | methenamine- Cystex, Hiprex, Urex |
| ____________ is a good fluid to drink when taking metheamine, because it acts a weak germicide and is used as a mild genitourinary antiseptic | cranberry juice |
| An OTC agent that has a local anesthetic effect on UTI | phenazopyridine- Pyridium, Azo-Standard, Uristat |
| First oral therapy for intestitial cystitus, and is used for relief of bladder pain | pentosan polysulfate sodium- Elmiron |
| Oxytrol minimizes the side effects of | dry mouth and constipation |
| Community-acquired _______ account for over five million physician visits each year. | UTI |
| The lower urinary tract consists of | urethra and bladder |
| The upper urinary tract consists of | ureters and kidneys |
| The prescence of __________ in the urine with localized symptoms is considered symptomatic of UTI. | bacteria |
| Symptoms of UTI | blood appears in the urine, urination may be difficult or painful, fever |
| The highest incidence of UTI occurs in what population? | sexually active women |
| Example of an lower urinary tract infection | urethritis |
| Example of an upper urinary tract infection | pyelonephritis |
| Antibiotics to treat UTI's | amoxicillin, amoxicillin-clavulanate, nitrofurantoin; Quinolone- ciprofloxacin |
| This antibiotic should be taken with plenty of water and a sunscreen should be used | smz-tmp |
| Quinolones should not be taken with ______________ and a sunscreen is needed | antacids, theophylline, warfarin, magnesium or calcium |
| Indicated for treatment of uncomplicated UTI's | ciprofloxacin- Cipro |
| ______ is one of the most common medical conditions occuring in older men. | BPH |
| An __________ becomes a problem wthen it obstructs urine outflow from the bladder | enlarged prostate |
| Increasing evidence shows that ______________, especially drug therapy, may be effective as a primary treatment for selected patients with BPH. | nonsurgical interventions |
| These drugs represent promising and innovative approaches to pharmocologic management of BPH. | alpha blockers and 5-alpha reductase inhibitors |
| ___________ were originally dev. for treating hypertension, and cause relaxation of smooth muscles, esp. in prostatic tissue, reducing many symptoms of BPH | alpha blockers |
| Certain types of drugs such as ___________ should not be used for patients with BPH | anticholinergics, oral bronchodilators, TCA's, antihistamines |
| Luteinzing hormones blockers that inhibit production of androgen | leuprolide- Eligard, Lupron Depot, Viadur; goserelin- Zoladex |
| _______ is an implant which is surgically inserted subcutaneously every 12 months and is used to treat carcinoma of the prostate | Viadur |
| _______ is a subcataneous implant in the abdomen every 28 days or 3 months | Zoladex |
| An antiandrogen that inhibits androgen uptake or binding of androgen in target tissues; used in combination with leuprolide in which both drugs must be started at the same time | flutamide- Eulexin |
| ______ is currently approved for treating symptomatic prostate cancer when used with a luteinizing hormone blocker such as leuprolide or goserelin. | flutamide |
| Crushed finasteride tablets or finasteride powder should be not be handled by who? | pregnant women or may become pregnant, because of a risk to a male fetus |
| Substance that increases the urine ouput | diurectic |
| Primary action of diurectics on the kidneys | to rid the body of excess fluid and electrolytes |
| A _____is often the first drug chosen to treat high blood pressure and may be also used to treat the various causes of edema | diurectic |
| _______ promote sodium and water excretion in the urine, lower the sodium level in vessel walls and reduce vasoconstriction | thiazide diurectics |
| Side effects of thiazide diurectics | hypokalemia, hypomagnesia, hyperuricemia, hyperglycemia, and hypercalacemia |
| Patients who take thiaz. diurectics should ingest _______ daily | potassium |
| _______ inhibit reabsorption of sodium and chloride in the ascending loop of Henle and distal renal tubules, causing increased urinary excretion of water, sodium, chloride, magnesium, calcium and potassium | loop diurectics |
| __________ result in the exchange of the sodium excreted in the urine for the potassium returned to the blood | potassium sparing diurectics |
| Patients on potass. sparing diurectics should take caution to taking _________ because these drugs also have a potass. sparing effect | ace inhibitors |
| _________ is an antagonist of aldosterone, which in itself will promote potassium sparing. | spironolactone |
| The only omsmotic diurectic on the market and is primarily used for cerebral edema or to decrease intraocular pressure | mannitol- Osmitrol |
| This tablet form of triametrene-hctz gives better absorption | Maxzide |
| Triametrene can change the urine to what color | blue-green |
| A related drug that inhibits sodium and chloride reabsorption in the cortical-diluting segment of the ascending loop of Henle | chlorthalidone- Hygroton |
| How should chlorthalidone be taken? | with food or milk early in the day, with multiple doses, the last dose should be taken no later than 6 pm to avoid nocturia |
| _________ a loop diurectic, should be dosed 20 mg to 40 mg at 6 to 8 hr intervals twice daily | furosemide- Lasix |
| The name of this drug was designed to indicated the six-hour interval | Lasix |
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