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lexipharm · 2008 April 8th, 03:07 AM

NAPLEX08, thankyou for your feedback. You are right, I looked it up and found that patients with bilateral renal artery stenosis predictably develop renal failure if treated with ACEIs, because in this case, glomerular filtration is maintained by angiotensin 2 mediated constriction of the efferent arteriole (due to low afferent arteriole pressure in this case).

On CPR (chap 56 - renal failure) ACE inhibitors are actually used to treat CHRONIC renal failure because "they help preserve renal function and delay progression of CKD". So ACEI's may cause ACUTE renal impairement. However they are beneficial in chronic renal failure since they treat the oedema and "they act preferentially on angiotensin-sensitive vascular beds, which include those of the kidney, and sustain adequate perfusion of these organs". So that is why when the compelling indication in hypertension is chronic renal failure, ACEI's can be used!

What do you think?

NAPLEX08 · 2008 April 8th, 03:51 PM

[quote=lexipharm;576411]NAPLEX08, thankyou for your feedback. You are right, I looked it up and found that patients with bilateral renal artery stenosis predictably develop renal failure if treated with ACEIs, because in this case, glomerular filtration is maintained by angiotensin 2 mediated constriction of the efferent arteriole (due to low afferent arteriole pressure in this case).

On CPR (chap 56 - renal failure) ACE inhibitors are actually used to treat CHRONIC renal failure because "they help preserve renal function and delay progression of CKD". So ACEI's may cause ACUTE renal impairement. However they are beneficial in chronic renal failure since they treat the oedema and "they act preferentially on angiotensin-sensitive vascular beds, which include those of the kidney, and sustain adequate perfusion of these organs". So that is why when the compelling indication in hypertension is chronic renal failure, ACEI's can be used!
WOW, Great job!
I`m studing a nd felt just fine with the groups, but this little detail opens up a lot of information. THANKS! I will play with the chapters as well. I`m using CPR and APhA mostly and I was going back to the chapter 15 I believe, but I was a great idea to look up the renal failure.

Let`s study more and share more questions! When are you getting ready to take NAPLEX? As for me I`m still looking for the company to do my 1000 hours of internship with. Then I will take NAPLEX and I live in VA. How about you?

NAPLEX08 · 2008 April 8th, 03:54 PM

Hi Lexipharm, I wanted to share this link with you. It helps me not to get bored with just reading so I can practice. Check it out!Enjoy!

Medical Pharmacology: Table_of_Contents

lexipharm · 2008 April 9th, 05:18 PM

Naplex 08, thanks a lot for that site. I love using these sites. Its an interesting way of studying without getting bored. When I was studying for FPGEE I used the following site

FPGEE practice questions and answers | Pharmainfo.net

I found it quite helpful. I am also using CPR and APhA and I joined the american pharmacist association and I am taking continuing education classes online. I find them very practical and I think these classes will help me improove my skills as a pharmacist apart from increasing my knowledge on the subject.

I am also living in VA by the way. I live in Chesapeake. I'm waiting to start my internship too (so I have a lot of time on my hands at the moment). I will be starting as soon as I receive my internship licence. I found an intern position with Wal-Mart. You said that you still have to do 1000 hours of internship? Isn't it 1500 hours in VA? Anyway, after internship, I'll take NAPLEX so I'm thinking it will probably be around January 2009.

Anyway, I'm almost done with hypertension because at the moment I'm focusing on reading and understanding the subject, and I'm not really trying to memorise much. After hypertension, I'll probably start diabetes because I'm getting bored of the CV system. I need to switch to something else. What about you?

Rubygq · 2008 April 9th, 10:57 PM

ACEI shouldn't be used during acute setting, but it's ok for chronic kidney disease. Because during acute kidney failure, as a reaction, the efferent arterioles of glomerulus constrict to be able to maintain the normal GFR, so that the kidney can maintain normal urine output. The constriction of efferent arteriole is regulated by angiotensin, therefore, if you block the angiotensin by ACEI, you block the natural response of kidney, which worsens the acute renal failure. But during chronic kidney disease, the chronic constriction of efferent arteriole is actually detrimental to kidney function. That's why it's better to use ACEI during chronic kidney failure.

lexipharm · 2008 April 10th, 12:52 AM

Rubygq that was so helpful. Thank you. We are going over the topics together and sharing information. Keep us posted and if you have any questions, we can work together to figure out the answer!
Lexi

Rubygq · 2008 April 10th, 02:20 AM

Hi, Lexipharm,
Do you have to pay to join APHP and take CE class online?

lexipharm · 2008 April 10th, 03:32 AM

Hi, I didn't pay for a pharmacist's membership. I paid for resident/graduate membership which was $60 as opposed to a pharmacists membership which was about $280. I don't really know what the difference between the two is, but I can take CE classes with this membership and I have access to their online journals too which is all I need at the moment! And their books have a discount for members. The discount is only a few dollars but its better than nothing. Anyway if I were you I would check out their site.
Hope this helps!

lexipharm · 2008 April 10th, 04:57 AM

Do B blockers effect triglyceride and cholesterol levels and if they do...how do they do this?

NAPLEX08 · 2008 April 10th, 05:37 PM

Quote:

Originally Posted by lexipharm

Naplex 08, thanks a lot for that site. I love using these sites. Its an interesting way of studying without getting bored. When I was studying for FPGEE I used the following site

FPGEE practice questions and answers | Pharmainfo.net

I found it quite helpful. I am also using CPR and APhA and I joined the american pharmacist association and I am taking continuing education classes online. I find them very practical and I think these classes will help me improove my skills as a pharmacist apart from increasing my knowledge on the subject.

I am also living in VA by the way. I live in Chesapeake. I'm waiting to start my internship too (so I have a lot of time on my hands at the moment). I will be starting as soon as I receive my internship licence. I found an intern position with Wal-Mart. You said that you still have to do 1000 hours of internship? Isn't it 1500 hours in VA? Anyway, after internship, I'll take NAPLEX so I'm thinking it will probably be around January 2009.

Anyway, I'm almost done with hypertension because at the moment I'm focusing on reading and understanding the subject, and I'm not really trying to memorise much. After hypertension, I'll probably start diabetes because I'm getting bored of the CV system. I need to switch to something else. What about you?

Hi Lexipharm,
I'm in Fredericksburg area. I`m thinking about joining Walmart if they will offer enough. By the way, how much did you sign up for and did you have to sign a contract?

Another question is about the sites that you mentioned with the pharmacists. Can you post those along with the cources? How much do they cost and what are you studing? I never heard about anything like that. Which country are you from? I'm from Russia.

Concerning 1000 hours of internship. I graduated in 2002 and I believe till 2003 graduates have to do 1000 hours , those who garduated after have to do 1500 hours.
Thanks for sharing the experience!

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2008 April 8th, 03:07 AM	#11 (permalink)
lexipharm I JUST got here. Join Date: Jan 2008 Posts: 27	NAPLEX08, thankyou for your feedback. You are right, I looked it up and found that patients with bilateral renal artery stenosis predictably develop renal failure if treated with ACEIs, because in this case, glomerular filtration is maintained by angiotensin 2 mediated constriction of the efferent arteriole (due to low afferent arteriole pressure in this case). On CPR (chap 56 - renal failure) ACE inhibitors are actually used to treat CHRONIC renal failure because "they help preserve renal function and delay progression of CKD". So ACEI's may cause ACUTE renal impairement. However they are beneficial in chronic renal failure since they treat the oedema and "they act preferentially on angiotensin-sensitive vascular beds, which include those of the kidney, and sustain adequate perfusion of these organs". So that is why when the compelling indication in hypertension is chronic renal failure, ACEI's can be used! What do you think?

2008 April 8th, 03:51 PM	#12 (permalink)
NAPLEX08 Eager! Join Date: Jan 2008 Posts: 57	[quote=lexipharm;576411]NAPLEX08, thankyou for your feedback. You are right, I looked it up and found that patients with bilateral renal artery stenosis predictably develop renal failure if treated with ACEIs, because in this case, glomerular filtration is maintained by angiotensin 2 mediated constriction of the efferent arteriole (due to low afferent arteriole pressure in this case). On CPR (chap 56 - renal failure) ACE inhibitors are actually used to treat CHRONIC renal failure because "they help preserve renal function and delay progression of CKD". So ACEI's may cause ACUTE renal impairement. However they are beneficial in chronic renal failure since they treat the oedema and "they act preferentially on angiotensin-sensitive vascular beds, which include those of the kidney, and sustain adequate perfusion of these organs". So that is why when the compelling indication in hypertension is chronic renal failure, ACEI's can be used! WOW, Great job! I`m studing a nd felt just fine with the groups, but this little detail opens up a lot of information. THANKS! I will play with the chapters as well. I`m using CPR and APhA mostly and I was going back to the chapter 15 I believe, but I was a great idea to look up the renal failure. Let`s study more and share more questions! When are you getting ready to take NAPLEX? As for me I`m still looking for the company to do my 1000 hours of internship with. Then I will take NAPLEX and I live in VA. How about you?

2008 April 8th, 03:54 PM	#13 (permalink)
NAPLEX08 Eager! Join Date: Jan 2008 Posts: 57	Hi Lexipharm, I wanted to share this link with you. It helps me not to get bored with just reading so I can practice. Check it out!Enjoy! Medical Pharmacology: Table_of_Contents

2008 April 9th, 05:18 PM	#14 (permalink)
lexipharm I JUST got here. Join Date: Jan 2008 Posts: 27	Naplex 08, thanks a lot for that site. I love using these sites. Its an interesting way of studying without getting bored. When I was studying for FPGEE I used the following site FPGEE practice questions and answers \| Pharmainfo.net I found it quite helpful. I am also using CPR and APhA and I joined the american pharmacist association and I am taking continuing education classes online. I find them very practical and I think these classes will help me improove my skills as a pharmacist apart from increasing my knowledge on the subject. I am also living in VA by the way. I live in Chesapeake. I'm waiting to start my internship too (so I have a lot of time on my hands at the moment). I will be starting as soon as I receive my internship licence. I found an intern position with Wal-Mart. You said that you still have to do 1000 hours of internship? Isn't it 1500 hours in VA? Anyway, after internship, I'll take NAPLEX so I'm thinking it will probably be around January 2009. Anyway, I'm almost done with hypertension because at the moment I'm focusing on reading and understanding the subject, and I'm not really trying to memorise much. After hypertension, I'll probably start diabetes because I'm getting bored of the CV system. I need to switch to something else. What about you?

2008 April 9th, 10:57 PM	#15 (permalink)
Rubygq I JUST got here. Join Date: Jul 2007 Location: Michigan Posts: 21	ACEI shouldn't be used during acute setting, but it's ok for chronic kidney disease. Because during acute kidney failure, as a reaction, the efferent arterioles of glomerulus constrict to be able to maintain the normal GFR, so that the kidney can maintain normal urine output. The constriction of efferent arteriole is regulated by angiotensin, therefore, if you block the angiotensin by ACEI, you block the natural response of kidney, which worsens the acute renal failure. But during chronic kidney disease, the chronic constriction of efferent arteriole is actually detrimental to kidney function. That's why it's better to use ACEI during chronic kidney failure.

2008 April 10th, 12:52 AM	#16 (permalink)
lexipharm I JUST got here. Join Date: Jan 2008 Posts: 27	Rubygq that was so helpful. Thank you. We are going over the topics together and sharing information. Keep us posted and if you have any questions, we can work together to figure out the answer! Lexi

2008 April 10th, 02:20 AM	#17 (permalink)
Rubygq I JUST got here. Join Date: Jul 2007 Location: Michigan Posts: 21	Hi, Lexipharm, Do you have to pay to join APHP and take CE class online?

2008 April 10th, 03:32 AM	#18 (permalink)
lexipharm I JUST got here. Join Date: Jan 2008 Posts: 27	Hi, I didn't pay for a pharmacist's membership. I paid for resident/graduate membership which was $60 as opposed to a pharmacists membership which was about $280. I don't really know what the difference between the two is, but I can take CE classes with this membership and I have access to their online journals too which is all I need at the moment! And their books have a discount for members. The discount is only a few dollars but its better than nothing. Anyway if I were you I would check out their site. Hope this helps!

2008 April 10th, 04:57 AM	#19 (permalink)
lexipharm I JUST got here. Join Date: Jan 2008 Posts: 27	Do B blockers effect triglyceride and cholesterol levels and if they do...how do they do this?

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