Cardiovascular

Question 1

AcetaZOLAMIDE

Answer 1

Inhibits carbonic anhydrase in the cells of the PCT of the nephron. Loss of Bicarb leads to loss of Na and consequently water. Causes metabolic acidosis, and alkalinizes the urine. Causes hypokalemia. Used to tx glaucoma, and also for high altitude sickness prophylaxis.

Question 2

Mannitol

Answer 2

Osmotic diuretic that acts in proximal tubule and the descending loop of Henle. Decreases intracranial & intraocular pressure (glaucoma & cerebral edema) via volume depletion.

Question 3

Furosemide/Bumetanide/Torsemide

Answer 3

Loop diuretics are sulfonamides that block the Na/K/2 Cl channel in the thick ascending loop. Used for volume overload states in CHF, Liver & Renal failure. Used for hypertension and hypercalcemia as well. Also causes ototoxicity, hyperuricemia, & Sulfa Allergies

Question 4

Ethacrynic Acid

Answer 4

Non-sulfonamide Loop Diuretic. Used in pt’s with sulfa allergies or gout.

Question 5

Thiazides/Chlorthalidone

Answer 5

Diuretic that inhibits Na/Cl co-transporter in Early DCT. Used for hypertension, nephrogenic DI (reduces polyuria), and recurrent kidney Ca stones. Causes Hypokalemia and hyperuricemia. Also impairs glucose tolerance.

Question 6

Spirolactone

Answer 6

Competitive aldosterone receptor antagonist. Works in CCT and LDT of nephron. Decreases potassium excretion. Causes hyperkalemia and gynecomastia. Treats Primary Hyperaldosteronism and volume overload in CHF (improves survival rates). Also used in hypertension.

Question 7

Eplerenone

Answer 7

Very similar to Spirolactone, aldosterone receptor antagonist. Doesn’t cause gynecomastia. Improves survival rates in CHF

Question 8

Triamterene/Amiloride

Answer 8

Blocks Sodium reabsorption in distal cortical collecting tubule. Decreases potassium excretion( causes hyperkalemia). Used for CHF (volume overload), and hypertension. Amiloride is used to treat Li-induced Nephrogenic DI.

Question 9

Desmopressin

Answer 9

Analog of ADH. Increases permeability of water in the collecting duct, therefore causing reabsorption of water and concentration of urine. Used in Central DI, also in Septic Shock and Cardiac Arrest. ALso increases Factor VIII activity. Can cause hyponatremia

Question 10

Caramazepine/Chlorpropamide

Answer 10

Enhances the action of ADH.

Question 11

Demeclocycline

Answer 11

Antibiotic that inhibits ADH. Used in SIADH (Small Cell Carcinoma). Also can causes nephrogenic DI.

Question 12

ConiVAPTAN

Answer 12

V2 antagonist of ADH. Tx for SIADH

Question 13

Clonidine

Answer 13

Alpha-2 agonist, that decreases central adrenergic activity (reduces NE release from medulla) and results in less vasoconstriction, as well as a drop in CO & HR. Used in Hypertension, cessation results in rebound hypertension. Contraindicated in pregnancy. Useful in renal disease (does not affect RBF). Can lower REM sleep.

Question 14

Methyldopa

Answer 14

Alpha-2 agonist, that decreases central adrenergic activity (reduces NE release from medulla) and results in less vasoconstriction. Used in pregnancy for moderate HT. Causes a positive Coombs test and orthostatic hypotension. Useful in renal disease (does not affect RBF)

Question 15

Guanethidine

Answer 15

Inhibits NE release from Symp. neurons, and causes gradual depletion. Not used anymore because it causes severe orthostatic hypotension –> shock

Question 16

PrAZOSIN

Answer 16

Selective Alpha-1 blocker. Dilates both resistance & capacitance vessels (used to treat HT). Causes “First dose syncope”. Attenuates over time, can increase ECF/Plasma volume over time.

Question 17

Tamulosin

Answer 17

Selective Alpha-1 blocker used to treat BPH. DOES NOT lower blood pressure.

Question 18

PropanOLOL

Answer 18

Beta blockers depress CO through HR & Contractility. This lowers MAP, thus how it is used in treating HT. Can cause Bronchoconstriction (blocking Beta-2).

Question 19

Timolol

Answer 19

Beta blocker used in wide-angle glaucoma

Question 20

Pindolol

Answer 20

Beta blocker that is a weaker in action. Used to tx pt’s with bradycardia & Hypertension

Question 21

Metoprolol

Answer 21

Selective Beta-1 blocker. Decreases HR & Contractility. Used to tx Hypertension, Tachycardia, & CAD, especially in pt’s with diabetes.

Question 22

Esmolol

Answer 22

Short-acting Beta-1 blocker, used for treating arrhythmia, HT, & MI.

Question 23

Carvedilol

Answer 23

Blocks Alpha-1 & Beta. Decreases HR & contractility. Used to treat hypertension. Used to treat CCHF with ACE inhibitors & diuretics. Can cause bronchoconstriction.

Question 24

Aliskiren

Answer 24

Renin inhibitor. Blocks renin, also causes an increase in renin (that doesn’t matter as long as you take the drug). Not used anymore.

Question 25

ACE inhibitors (-PRIL)

Answer 25

Inhibit Angiotension Converting Enzyme (AT1 –> AT2). Prevents AT2-induced vasoconstriction and Aldosterone production. Used to treat HT & CHF. Also used to tx & prevent diabetic neuropathy. Improves survival in post-MI pt’s. Causes a COUGH, and can cause angioedema