RT Book, Section
A1 Lau, Alan H.
A2 DiPiro, Joseph T.
A2 Talbert, Robert L.
A2 Yee, Gary C.
A2 Matzke, Gary R.
A2 Wells, Barbara G.
A2 Posey, L. Michael
SR Print(0)
ID 1145186797
T1 Glomerulonephritis
T2 Pharmacotherapy: A Pathophysiologic Approach, 10e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259587481
LK accesspharmacy.mhmedical.com/content.aspx?aid=1145186797
RD 2024/04/24
AB KEY  CONCEPTS  Glomerulonephritis  is  a  collection  of  glomerular  diseases  mediated  by  different  immunologic  pathogenic  mechanisms,  resulting  in  varied  clinical  presentation  and  therapeutic  outcomes.  The  signs  and  symptoms  associated  with  glomerulonephritis  are  commonly  nephrotic  in  nature  and  characterized  by  proteinuria.  At  times,  there  may  be  nephritic  features,  characterized  by  inflammatory  injury.  Supportive  treatments  for  edema,  hypertension,  hyperlipidemia,  and  intravascular  thrombosis  are  important  in  reducing  the  complications  associated  with  glomerulonephritis.  These  are  especially  important  since  specific  and  effective  therapy  for  many  types  of  glomerulonephritis  are  not  available.  Reduction  of  proteinuria  can  often  improve  long-term  kidney  and  patient  outcomes.  To  maximize  therapeutic  benefits  and  minimize  drug-induced  complications,  patients  have  to  be  monitored  closely  to  assess  their  therapeutic  responses  as  well  as  the  development  of  any  treatment-induced  toxicities.  Among  all  the  types  of  glomerulonephritis,  minimal-change  nephropathy  is  most  responsive  to  treatment.  Steroids  can  induce  good  responses  in  most  patients  during  initial  treatment  as  well  as  relapse.  Because  of  the  lack  of  consistently  effective  treatment  for  primary  focal  segmental  glomerular  sclerosis,  angiotensin-converting  enzyme  inhibitors  or  angiotensin  receptor  blockers  are  commonly  used  for  patients  with  mild  disease  to  control  symptoms.  Steroids  and  immunosuppressive  agents  are  reserved  for  the  management  of  patients  with  severe  disease.  The  optimal  treatment  for  lupus  nephritis  depends  on  the  underlying  lesion  and  disease  activity,  as  well  as  the  severity  and  duration  of  the  patient’s  condition.  The  treatment  of  poststreptococcal  glomerulonephritis  is  mainly  supportive  and  symptomatic.  Antibiotic  therapy  does  not  prevent  subsequent  disease  development  but  may  reduce  the  severity.