2022 NEW STUDY GUIDE SOLUTION EXAM FOR PHARMACOLOGY II (RENAL IMPAIRMENT)

2022 NEW STUDY GUIDE SOLUTION EXAM FOR PHARMACOLOGY II (RENAL
IMPAIRMENT)
What is AKI? - -acute/sudden deterioration in kidney function


What is pre-renal AKI? - -decreased renal prefusion = decreased GFR
-caused by
1.) cardiogenic shock
2.) hemorrhage
3.) renal artery obstruction


What is intra-renal AKI? - -damage to kidney tissue
-caused by
1.) acute tubular necrosis


What is post-renal AKI? - -urinary tract obstruction
-caused by
1.) stones
2.) infection
3.) enlarged prostate


What is the AKI onset phase? - -the triggering event
-no symptoms yet
--blood flow and tissue O2 is normal


What is the AKI oliguric phase? - 1.) decreased UO <400 ml/day

, 2.) increased BUN, CR, K+, phosphate


What is the AKI diuretic phase? - kidneys are starting to reverse a little bit, causes
corrected
1.) UO >400 ml/day
2.) increased GFR
3.) electrolytes may be corrected


What is the AKI recovery phase? - several months to 1 year after, normal function
of kidney restored
1.) decreased edema
2.) normal GFR, CR, BUN, K+


What are the s/sx of AKI? - 1.) decreased UO, increased BUN and CR
2.) fluid retention
-pitting edema
3) SOB, increased RR
4.) drowsiness, confusion, fatigue, coma
5.) seizures/tremors (asterixis)
6.) chest pain, dysrhythmias


What are typical AKI labs and tests? - oliguria: <400 ml/24 hrs
GFR
-90-120 ml/min