Cardiovascular: Drugs

Question 1

what type of drug is furosemide?

Answer 1

loop diuretic

Question 2

Mechanism of action of furosemide?

Answer 2

As their name suggests, loop diuretics act principally on the ascending limb of the loop of Henle, where they inhibit the Na+/K+/2Cl−co- transporter. Water then follows by osmosis.

Question 3

Indications of furosemide?

Answer 3

1. for relief of breathlessness (acute pulmonary oedema)
2. chronic heart failure
3. other oedematous states

Question 4

Contra-indications of furosemide?

Answer 4

• hypovolemia
• dehydrated
• hepatic encephalopathy
• hypokalaemia
• hyponatraemia
• gout (can make it worse)

Question 5

Side-effects of furosemide?

Answer 5

• possible dehydration
• possible hypotension
• low electrolyte state
• hearing loss
• tinnitus

Question 6

Possible interactions (and mechanism) of furosemide?

Answer 6

Loop diuretics have the potential to affect drugs that are excreted by the kidneys.

toxicity increased for:

• digoxin
• aminoglycosides
• lithium levels

Question 7

Elimination of furosemide?

Answer 7

65% of furosemide is excreted unchanged in the urine, and the remainder is conjugated to glucuronic acid in the kidney.

Question 8

how is furosemide administered?

Answer 8

Oral or IV

Question 9

what effect do loop diuretics have on blood vessels?

Answer 9

dilatation of capacitance veins.

Question 10

what type of drug is bendroflumethiazide?

Answer 10

thiazide diuretic

Question 11

Mechanism of action of bendroflumethiazide?

Answer 11

Thiazides inhibit the Na+/Cl− co-transporter in the distal convoluted tubule of the nephron. This prevents reabsorption of sodium and its osmotically associated water.

Question 12

Indications of bendroflumethiazide?

Answer 12

1. alternative first-line treatment for hypertension where a calcium channel blocker would otherwise be used but is unsuitable
2. add on treatment for hypertension (who’s BP isn’t controlled by calcium channel blocker and ACEI)

Question 13

Contra-indications of bendroflumethiazide?

Answer 13

• hypokalaemia
• hyponatraemia
• gout

Question 14

Side-effects of bendroflumethiazide?

Answer 14

• hyponatraemia
• hypokalaemia (which may lead to cardiac arrhythmia)
• impotence in men

Question 15

Possible interactions (and mechanism) of bendroflumethiazide?

Answer 15

• The effectiveness of thiazides may be reduced by non-steroidal anti-inflammatory drugs (low dose aspirin not a concern)
• loop diuretics (will lower the serum potassium)

Question 16

which type of diuretics act on the loop of henle?

Answer 16

loop diuretic

Question 17

which type of diuretics act on the distal convoluted tubule?

Answer 17

thiazide diuretic

Question 18

which type of diuretics act on the distal convoluted tubule?

Answer 18

thiazide diuretic