Diuretics

Question 1

Prostaglandin effect on afferent arteriole

Answer 1

Vasodilation

Question 2

Angiotensin II effect on efferent arteriole in kidney

Answer 2

Vasoconstriction

Question 3

Thiazide diuretics MOA:

Answer 3

Inhibit Na+/Cl- co-transporter reaborbtion in distal tubule

Question 4

Adverse effects of thiazide diuretics (5)

Answer 4

Hypokalemia,
Hyponatremia,
Hypercalcemia
Hyperglycemia
Hyperlipidemia

Question 5

Indications for thiazide diuretics (4)

Answer 5

1. Hypertension
2. Edema from CHF, liver/kidney disease
3. Hypercalciuria
4. Nephrogenic diabetes insidious

Question 6

Thiazide use for nephrogenic diabetes insipidus is not effective when:

Answer 6

GFR is less than 30 ml/min

Question 7

Loop diuretics MOA:

Answer 7

Inhibit sodium resorption in thick ascending limb blocking Na+/K+/Cl- co-transporter.

Question 8

Loop diuretics induce:

Answer 8

COX2 increasing PGE2 causing vasodilation

Question 9

Loop diuretics increase urinary excretion of (5)

Answer 9

Na
K
Mg
Ca
Cl

Question 10

Loop diuretics indications: (6)

Answer 10

Acute pulmonary edema 
CHF
Edema of nephrotic syndrome 
Acute renal failure
Hyperkalemia
Hypercalcemia

Question 11

Sodium channel blockers used to spare potassium (2)

Answer 11

Amiloride

Triamterene

Question 12

Spironoactone MAO:

Answer 12

Block aldosterone receptor at distal tubule and inhibit aldosterone-stimulated synthesis of ENaC and Sodium potassium pump

Question 13

Spironolactone is more useful in ________ because of duration of effect of _____-_____ hours

Answer 13

Nephrotic syndrome;

24-48 hours

Question 14

Eplerenone is better tolerated because

Answer 14

It does not bind androgen receptors

Question 15

Because spironolactone binds to androgen receptors it will cause

Answer 15

Gynecomastia and hirsutism

Question 16

What will increase lithium clearance?

Answer 16

Sodium channel blockers (ENaC)

Question 17

What diuretic may cause hirsutism?

Answer 17

Spironolactone

Question 18

Site of action of carbonic anhydride inhibitors

Answer 18

Proximal tubule

Question 19

Name some Diuretics that may cause hypokalemia

Answer 19

Thiazides and loop diuretics and Carbonic Anhydrase Inhibitors

Question 20

Name a carbonic anhydrase inhibitor:

Answer 20

Acetazolamide

Question 21

Indications for acetazolamide (2)

Answer 21

Glaucoma, mountain sickness

Question 22

Mannitol MAO:

Answer 22

Expands extra cellular fluid and increases GFR

Question 23

Do not use mannitol in patients with

Answer 23

CHF

Pulmonary edema

Question 24

Effect of Conavaptan:

Answer 24

Decrease water reabsorption, increase plasma sodium, vasodilation

Question 25

Oral vasopressin antagonist

Answer 25

Tolvaptan

Question 26

Treat a patient with increased incranial pressure With:

Answer 26

Mannitol

Question 27

Possible ototoxicity from which diuretic class?

Answer 27

Loop diuretics