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OSCE Pharmacology > CVS drugs - Diuretics and anti-fat > Flashcards

CVS drugs - Diuretics and anti-fat Flashcards

1
Q

When is mannitol used?

A

Raised ICP

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2
Q

Give a CI for mannitol

A

Congestive heart failure

Pulmonary oedema

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3
Q

What is the mechanism of aciton of mannitol?

A

 Freely filtered at the glomerulus, but only partially, if at all, reabsorbed
 Passive water reabsorption is reduced by the presence of this non-reabsorbable solute within the tubule lumen

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4
Q

What are two ADRs of mannitol?

A

Chills and fever

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5
Q

When would you use thiazide diuretic?

A

Hypertension

Oedema

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6
Q

Give mechanism of action of thiazide diuretics

A

Inhibit NaCl symporter in luminal membrane, more Na+ in tubule

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7
Q

Give four ADRs of thiazide diuretics

A 
Hypokalaemia 
Hyperuriciaemia
Impaired glucose tolerance 
Hyponatraemia 
Hyper calcaemia 
Metabolic alkalosis
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8
Q

Give four thiazide DDIs

A

Steroids - Increase risk of hypokalaemia
Beta blockers - Hyperglycaemia
Digoxin - Hypokalaemia increases digoxin binding and toxicity
Carbamezapine - Increased risk of hyponatraemia

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9
Q

When would you use loop diuretics?

A

Acute pulmonary oedema
Oliguria
Resistant heart failure
Hypertension

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10
Q

What is the mechanism of action of loop diuretics?

A

Inhibit NKCC2 channel at thick ascending limb

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11
Q

Give some ADRs of loop diuretics

A

 Hypokalaemia, Hyponatraemia, hyperuricaemia (can preciptitate gout), hypotension, hypovolaemia, metabolic alkalosis

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12
Q

What can furosemide cause specifically?

A

Ototoxicity

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13
Q

How do loop diuretics interact with digoxin?

A

May cause hypokalaemia, increasing digoxin binding

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14
Q

How do aminoglycosides mess with digoxin?

A

Interact with loop diuretics and increases risk of ototoxicity and potential hearing loss

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15
Q

Give two potassium sparing diuretics

A

Amiloride

Spironolactone

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16
Q

When are potassium sparing diuretics used generally?

A

In conjunction with other diuretics for heart failure and hypertension

17
Q

What can spironolactone be used for specifically?

A

Hyperaldosteronism

18
Q

What does amiloride do?

A

Blocks Na+ reabsorption

19
Q

What are some ADRs of spironolactone?

A

Hyperkalaemia
Hyponatraemia
Spironolactone - gynaecomastia, mestural disorders

20
Q

How is digoxin a diuretic?

A

Inhibits tubular Na/K ATPase?

21
Q

How does Lithium work as a diuretic

A

ADH antagonist

22
Q

How do you treat hyperkalaemia?

A

IV calcium gluconate

23
Q

How do statins work?

A

 HMG-CoA Reductase inhibitor. Prevents cholesterol synthesis in the liver. Lower liver cholesterol concentration stimulates the production of LDL receptors, increasing the rate of LDL removal from plasma.

24
Q

What are three main ADRs of statins?

A

Myopathy
Arthralgia
Headaches

25
Q

What drugs effect statins significantly?

A

Cyp450 inducers/inhibitors

26
Q

How much do statins decrease things?

A

o LDL reduction of between 5-35%,
o HDL raised by ~5%
o Triglycerides reduction of 10-35%

27
Q

Give four lipid lowering drugs

A

Fibrates
Statins
Cholesterol absorption inhibitors
Bile Acid Sequesterant

28
Q

What is the mechanism of fibrates?

A

PPAR-a agonist

29
Q

What is PPAR?

A

Major regulator of lipid metabolism in the liver

Activation promotes uptake, catabolization and utilization of lipids

30
Q

What do fibrates do?

A

LDL lowering
HDL increase in 15-25% in hypertriglyceridaemia
Decreases Triglycerides 25-50%

31
Q

Give some adverse drug reactions to fibrates

A

Gastrointestinal disturbances
Impotence
Dermatitis
Headache

32
Q

What happens if you take fibrates with statins?

A

Myalgia and myopathy

33
Q

What do cholesterol absorption inhibitors act on?

A

Intestinal cholesterol uptake - NPC1L1 in brush border.

34
Q

What does a single dose of cholesterol absorption inhibitor do?

A

Reduces LDL by 15-20%

35
Q

Give two ADRs of cholesterol inhibitors

A

Diarrhoea, pain

Headache

36
Q

What do bile acid sequesterants do?

A

o Bind to bile acids in the intestine. This prevents their reabsorption and subsequent conversion of hepatic cholesterol into bile acids. Lower levels of hepatic cholesterol leads to increased LDL receptor expression and lowered plasma cholesterol concentration.

37
Q

Why don’t bile acid sequestrants cause systemic ADRs?

A

Not well absorbed - Do cause

Nausea, vomiting, constipation, abdominal pain, flatulence, heart burn

OSCE Pharmacology (10 decks)

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