Renal Pharmacology for Dialysis Nurses Flashcards

Which medication used to lower blood pressure is dialyzable and may require supplemental dosing after hemodialysis?

Answer: Atenolol

Atenolol is hydrophilic, minimally protein-bound, and substantially removed by hemodialysis, often requiring a supplemental post-dialysis dose.

Sodium bicarbonate is sometimes given to a dialysis patient prior to an emergency session. What is the indication?

Answer: Hyperkalemia with severe acidosis

IV sodium bicarbonate can temporarily shift potassium intracellularly and correct severe acidosis as a bridge to urgent hemodialysis.

A dialysis patient develops severe hypocalcemia during a session using a low-calcium dialysate. What is the preferred treatment?

Answer: IV calcium gluconate

Symptomatic acute hypocalcemia requires IV calcium gluconate for rapid correction, as oral calcium acts too slowly.

Which drug class is commonly used to treat restless leg syndrome in dialysis patients?

Answer: Dopamine agonists

Dopamine agonists such as pramipexole and ropinirole are first-line treatments for restless leg syndrome, which is highly prevalent in dialysis patients.

Gabapentin requires significant dose reduction in dialysis patients primarily because of:

Answer: Renal elimination and accumulation causing CNS toxicity

Gabapentin is renally excreted and accumulates in ESRD, leading to excessive sedation, confusion, myoclonus, and respiratory depression.

Which medication is used to treat pruritus (itching) in dialysis patients refractory to antihistamines?

Answer: Naltrexone or difelikefalin

Naltrexone (opioid antagonist) and difelikefalin (kappa-opioid receptor agonist) target uremic pruritus pathways and are used when standard antihistamines fail.