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Renal II > Anti-hypertensives > Flashcards

Anti-hypertensives Flashcards

1
Q

Initial therapy for pts with chronic kidney disease (2)

A
  1. ACE inhibitors

2. ARBS (Ang receptor blockers)

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2
Q

Initial treatments for black pts (2)

A
  1. Thiazide diuretics

2. CCB

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3
Q

Initial treatments for non black pts (4)

A
  1. Thaizide diuretics
  2. ACE inhibitor
  3. ARB
  4. CCB
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4
Q

Carbonic Anhydrase Inhibitors MOA

A

inhibits the membrane-bound and cytoplasmic forms of carbonic anhydrase

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5
Q

Carbonic Anhydrase Inhibitors changes in blood urine pH

A

urine pH - increases
body pH - decreases
–> results in acidosis

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6
Q

Carbonic Anhydrase Inhibitors results in (4)

A
  1. decrease in H formation inside the cell
  2. decreased Na/H anti-port
  3. Increased Na and HCO3 inside the lumen (urine)
  4. increased dieresis
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7
Q

Drug class: -zolamide

A

Carbonic Anhydrase Inhibitors

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8
Q

Adverse effects: Carbonic Anhydrase Inhibitors (5)

A
  1. sulfonamide hypersensitivity
  2. acidosis,
  3. hypokalemia,
  4. renal stones,
  5. paresthesias
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9
Q

Use: Carbonic Anhydrase Inhibitors (3)

A
  1. glaucoma,
  2. acute mountain sickness,
  3. metabolic alkalosis
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10
Q

Drug class: ethacrynic acid

A

Loop Diuretics

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11
Q

MOA: Loop Diuretics

A

inhibit the luminal Na+/K+/2Cl- cotransporter (NKCC2) in the TAL of the loop of Henle

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12
Q

Adverse Effects of Loop Diuretics: (7)

A
  1. hypokalemia,
  2. alkalosis,
  3. hypocalcemia,
  4. hypomagnesemia,
  5. hyperuricemia,
  6. ototoxicity,
  7. sulfonamide hypersensitivity
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13
Q

Uses of Loop Diuretics: (7)

A
  1. hypokalemia,
  2. alkalosis,
  3. hypocalcemia,
  4. hypomagnesemia,
  5. hyperuricemia,
  6. ototoxicity,
  7. sulfonamide hypersensitivity
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14
Q

Thiazide Diuretics MOA:

A

cause inhibition of the Na+/Cl- cotransporter (NCC) and block NaCl reabsorption in the DCT

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15
Q

_______enhance the reabsorption of ____ in both DCT and PCT

A

Thiazide Diuretics

Ca2+

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16
Q

_____ should be used with caution in patients with DM

A

Thiazide Diuretics

17
Q

Thiazide Diuretics adverse effects (7) first 2 important!

A
  1. hyperglycemia,
  2. hyperlipidemia,
  3. hypercalcemia,
  4. hyperuricemia,
  5. hypokalemia
  6. alkalosis,
  7. sulfonamide hypersensitivity
18
Q

Adverse effects of ENaC inhibitors (2)

A

Hyperkalemia, acidosis

19
Q

Adverse effects of Mineral corticoid receptor antagonists (2)

A

hyperkalemia, acidosis, and antiandrogenic effects

20
Q

The mineralocorticoid receptor is also know as the _____ and in a ______ receptor

A
  • aldosterone receptor

- nuclear hormone receptor

21
Q

These two antihypertensive agents increase body pH and cause alkalosis

A
  1. loop agents

2. Thiazides

22
Q

These two antihypertensive agents decrease body pH and cause acidosis

A
  1. Carbonic anhydrase inhibitors

2. K+ sparing agents

23
Q

Ang II effects on the kidney

A

Na retention

H2O retention

24
Q

Ang II effects on the Brain

A

stimulate thirst

25
Q

Ang II effects on Adrenal gland

A

aldosterone

26
Q

Ang II effects on vessels

A

vasoconstriction –> increased BP

27
Q

What 3 drug classes are contraindicated in Pregnancy?

A
  1. ACE inhibitors
  2. ARBS
  3. Renin inhibitors
28
Q

ACE inhibitor MOA

A
  • prevent the conversion of ang I to ang II

- prevent the degradation of bradykinin (vasodilator)

29
Q

ACE inhibitor clinical indications (5)

A
  1. HTN
  2. Heart failure
  3. Left ventricular dysfunction
  4. prevent CV events (MI, Stroke)
  5. Nephropathy (+/- diabetes)
30
Q

Adverse effects of Ace inhibitors (4)

A
  1. Cough
  2. Angioedema
  3. hyperkalemial
  4. acute renal failure
31
Q

____ prevent/delay the progression of renal disease in ______ and patients with __________.

A
  • ACEIs
  • type I diabetics
  • non-diabetic nephroapathies
32
Q

ACEIs vasodilate ____ > ______ arterioles.

A

efferent over afferent

33
Q

ACEIs usually improve renal blood flow adn Na excretion rate n ____

A

CHF

Renal II (5 decks)

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