Tuesday, June 11, 2013

Wild Nephrology Explored

Last week we had three questions regarding plants that were related to Nephrology.

Wild Nephrology Part 1: Name the " Electrolyte disorder" most commonly associated with this plant.
This is FloxGlove, the plant that is where we get digoxin from. The best-known species is the common foxglove, Digitalis purpurea. This biennial plant has vivid flowers which range in color from various purple tints through various shades of light gray, and to purely white.
Digoxin inhibits Na-K ATPase as a results K remains outside the cells and results in hyperkalemia. Since K and digoxin compete for the same pump, hypokalemia can make digoxin toxicity worse. So, both Kalemias are associated with this agent- one that worsens the toxicity and other as a result of toxicity. 

Wild Nephrology Part 2: Name the "electrolyte disorder" associated with this plant.
This is Opium Poppy and the most likely disorder is hyponatremia as a result of extreme nausea. 

Wild Nephrology Part 3: The drug from this plant has to be dose adjusted in CKD. Name the plant and the drug
This is Pacific Yew(Taxus brevifolia)The chemotherapy drug paclitaxel (taxol), used in breastovarian, and lung cancer treatment, is derived from Taxus brevifolia. Dose adjustment is needed for this chemotherapy in CKD patients. There are no FDA-approved labeling guidelines for dosage adjustment in patients with renal impairment. Experts recommend no dosage adjustment necessary for adults with Clcr<50 mL/minute but many do adjust. 

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