asmi
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What is the antihypertensive drug of choice for a pt with renal insufficiency ?
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| Quinn
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Captopril?
What is the DOC for hypertensive emergencies?
Which can be used to prevent premature labor in pregancy?
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| anne
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well--- i guess captopril is renaltoxic,as are other ACE inhibitors and AT-i receptor antagonists.
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| anhthu
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I think Loop diuretic or center acting adrenergic drugs such as: Clonidine or Alpha Methyldopa
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| anne
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methyldopa is the DOC in renal insufficiency and pregnancy.
nitroprusside DOC in hypertensive emergencies(I/V)
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| asmi
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I agree with anne..since ACEI cannot be used in renal insufficiency pt( he may go into acute renal failure)
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| satheesh
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what is the anti hypertensive of choice of Diabetic nephropathy? what is the reason to have chance of acute renal failure on using captopril?
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satheesh
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| anne
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antihypertensives of choice in diabetes are ACE inhibitors and AT_1 antagonists.they have a risk of developing acute renal failure esp in pts with renal artery stenosis probably because of the vasoconstrictor effect of Angiotensin-II.
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| asmi
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in diabetic nephropathy its ACEI ..
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| satheesh
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ACE inhibitors makes angiotension 2 unvailable which prevents efferent aretriole constrition. if you have more, reply me
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satheesh
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| asmi
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do you mean't to say No ?
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| satheesh
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yes you are correct. i explained about mechanism about Acute renal failure on using ACE inhibitors.
can you explain NSAID can also cause ARF what is the mechanism?
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satheesh
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| asmi
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do u have any refernce for that ?
I know that ACEI can be used in diabetic nephropathy ..
also At-1 and diuretics
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| satheesh
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I dont have reference, sorry. i will refer. let me know what is the mechanism for ARf on using NSAID, i read in undergraduation but i am unable to recollect.
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satheesh
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| asmi
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its via decreasing PG 's
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| satheesh
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Decreasing PG"s, you are correct this is the reason for Pre renal ARF. what is the reason for Analgesic nephropathy which has complete different pic.
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satheesh
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| asmi
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its interstitial nephritis ..renal papillary necrosis..........via free radical..for PCM and PG's for ASA
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| satheesh
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you are excellent, tx
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satheesh
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| Quinn
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Great discussion. Nice question asmi.
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