Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NU 607 Pharm Quiz 2 > Diuretics, ACEs, ARBs, CCBs > Flashcards

Diuretics, ACEs, ARBs, CCBs Flashcards

1
Q

hydrochlorothiazide, indapamide, chlorothiazide, chlorthalidone, methylclothiazide

A

thiazide diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

furosemide, bumetanide, ethacrynic acid, torsemide

A

loop diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

amiloride, spironolactone, triamterene

A

potassium-sparing diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

prototype: thiazide

A

hydrochlorothiazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

prototype: loop

A

furosemide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

prototype: potassium-sparing (2)

A

spironolactone & triamterene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

which diuretic acts in the ascending loop of Henle to inhibit sodium and chloride reabsorption?

A

loop diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

indications for loop diuretics (4)

A
  1. edema r/t HF
  2. edema r/t renal disease or liver failure
  3. hypertension that cannot be control with thiazide or potassium sparing diuretics
  4. patients who need diuretic therapy but have low renal blood flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

ototoxicity is a side effect in which diuretic class?

A

loop diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

electrolytes excreted with the majority of diuretics

A

sodium, chloride, potassium, hydrogen, calcium, magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

most powerful diuretic class?

A

loop diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

diuretic class most commonly used in HF

A

loop diuretics (furosemide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

which diuretic class is effective in treating pulmonary edema & mod./severe CHF

A

loop diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

adverse effects with loop diuretics include (5)

A
  • electrolyte imbalances (hypokalemia, hyponatremia, hypochloremia, hypomagnesemia, hypocalcemia)
  • dehydration
  • hypovolemia/hypotension
  • hyperuricemia
  • ototoxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

drug interactions with loop diuretics (6)

which one is a positive interaction?

A
  • potassium sparing diuretics (positive, helps counterbalance K+ loss)
  • NSAIDs
  • digoxin
  • ototoxic drugs
  • lithium
  • antihypertensive drugs (hypotension)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

which class of medications can blunt loop diuretic effects?

A

NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

monitoring for loop diuretics

A
  • monitor BP & pulse
  • daily weights
  • intake and output
  • monitor for decreased edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

which diuretic acts in the distal convoluted tubule, decreasing reabsorption of sodium and increasing sodium & water excretion into the urine?

A

thiazides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

which diuretic class is associated with HYPERcalcemia?

A

thiazides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

indications for thiazide diuretics (2)

A
  • essential HTN

- edema in mild HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

which diuretic class is ineffective in patients with eGFR < 30-40?

A

thiazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

if eGFR < 30-40, which diuretic class should be used?

A

furosemide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

thiazides should be used in caution with patients suffering what kind of impairments?

A

renal and liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

the eGFR in which thiazides have their best efficacy

A

when eGFR is normal (> 90 mL/min), thiazides are most effective
- These drugs are ineffective when GFR is < 15-20 mL/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

the ability of thiazides to promote diuresis is dependent on what?

A

adequate kidney fx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

adverse effects for thiazide diuretcs (6)

A
  • hypokalemia
  • hypomagnesemia
  • HYPERcalcemia
  • HYPERglycemia
  • HYPERuricemia
  • HYPERlipidemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

which diuretic should be used cautiously with gout?

A

thiazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

which diuretic should be used cautiously with diabetes?

A

thiazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

drug interactions with thiazide diuretics (5)

which one is a positive interaction?

A
  • potassium sparing diuretics (positive, helps counterbalance K+ loss)
  • NSAIDs
  • digoxin
  • lithium
  • antihypertensive drugs (hypotension)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

drug interaction differences between loop & thiazide diuretics?

A

thiazides CAN be combined with ototoxic agents without increasing risk of hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

In treatment of hypertension, what determines the use of a loop diuretic vs thiazide diuretic?

A

Loop diuretic will only be used in place of thiazide diuretic when HTN is uncontrolled with other diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

diuretic class most commonly used in HTN

A

thiazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

monitoring for thiazide diuretics

A
  • monitor BP & pulse
  • daily weights
  • intake and output
  • monitor for decreased edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

which diuretic acts on the late distal tubule and collecting duct?

A

potassium-sparing (triamterene)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

which diuretic blocks the action of aldosterone?

what does this cause?

A

potassium-sparing (spironolactone)

–> causes retention of potassium & increased excretion of sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

indications for potassium-sparing diuretics (3)

A

HTN, edema, HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

adverse effects of potassium-sparing diuretics (2)

A
  • hyperkalemia

- endocrine effects (gynecomastia & impotence)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

which diuretic is associated with hyperkalemia

A

potassium-sparing diuretics

39
Q

are potassium-sparing diuretics used as monotherapy?

A

no - generally combined with thiazide or loop

40
Q

drug interaction of potassium-sparing diuretics with thiazides and loop diuretics

A

counteracts the potassium-wasting effects of the more powerful diuretic

41
Q

agents that raise potassium levels must be used with caution in which diuretic class? what are these agents?

A

potassium-sparing (salt substitutes, potassium supplements, or another K+ sparing diuretic) in addition to ACEs, ARBs, and DRIs

42
Q

monitoring for potassium-sparing diuretics

A
  • monitor K+ level
43
Q

contraindications for potassium-sparing diuretics

A

those with hyperkalemia

44
Q

caution should be used in potassium-sparing diuretics for patients taking what?

A

ACEs, ARBs, or DRIs

45
Q

caution should be used with thiazides for patients with what conditions (4) or taking what meds (3)?

A
  • cardiac disease
  • renal impairment
  • diabetes
  • history of gout
  • dig, lithium, anti hypertensives
46
Q

caution should be used with loop diuretics for patients with what conditions (4) or taking what meds (5)?

A
  • cardiac disease
  • renal impairment
  • diabetes
  • history of gout
  • dig, lithium, ototoxic drugs, NSAIDs, anti hypertensives
47
Q

3 determinants of BP

A
  1. mean arterial pressure
  2. cardiac output
  3. peripheral vascular resistance
48
Q

most commonly used diuretic for HTN

A

thiazide

49
Q

most cost effective diuretic used for HTN

A

thiazides

50
Q

ACE inhibitor prototype

A

captopril

51
Q

-prils belong to what drug class?

A

ACE inhibitors

52
Q

benazepril, captopril, enalapril, enalaprilat, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril

A

ACE inhibitors

53
Q

which drug class reduces levels of angiotensin II and increases levels of bradykinin

A

ACE inhibitors

54
Q

main difference between mechanism of actions between ACEs and ARBs

A

ARBs block the actions of angiotensin II, whereas ACE inhibitors block the formation of angiotensin II

55
Q

contraindications for ACE inhibitors (3)

A
  1. Pregnancy
  2. Bilateral renal artery stenosis (or stenosis in artery to single remaining kidney)
  3. History of hypersensitivity reactions (especially angioedema) to ACE inhibitors
56
Q

caution should be used when prescribing ACEs to which patients (3) or taking which meds (4)?

A
  • salt/volume depletion
  • renal impairment
  • collagen vascular disease
    OR
  • K+ supplements, salt substitutes, K+ sparing diuretics
  • ARBs
  • aliskiren
  • lithium
57
Q

indications for ACE inhibitors (6)

A
  • HTN
  • HF
  • MI
  • diabetic & non-diabetic nephropathy
  • prevention of MI, stroke and death in pt. with high CV risk
  • diabetic retinopathy
58
Q

adverse effects with ACEs (what’s the big one?) (7)

A

COUGH

  • hypotension** first dose hypotension
  • rash
  • angioedema
  • hyperkalemia
  • renal failure
  • neutropenia
59
Q

drug interactions for ACE inhibitors(5)

A
  • diuretics
  • antihypertensive agents
  • drugs the elevate potassium levels
  • lithium
  • NSAIDs
60
Q

first line hypertensive medication classes (4)

A
  • thiazides
  • ACEs
  • ARBs
  • CCBs
61
Q

which drug class is good for patients with HTN & DM or HTN & CHF?

A

ACEs

62
Q

which drug class can slow the progression of neuropathy?

A

ACEs

63
Q

monitoring for ACEs (5)

A
  • monitor BP closely
  • obtain CBC
  • monitor for reduced BP (140/90)
  • monitor for reduced s/s HF
  • monitor for protienuria & GFR
64
Q

which drug class blocks the angiotensin II receptor, inhibiting the action of angiotensin II

A

ARBs

65
Q

-sartan belongs to which drug class?

A

ARBs

66
Q

ARB prototype

A

losartan

67
Q

azilsartan, candesartan, eprosartan, irbesartan, losartan, olmesartan, telmisartan, valsartan

A

ARBs

68
Q

which drug class is an alternative to ACE inhibitors if cough is a problem?

A

ARBs

69
Q

indications for ARBs (7)

A
  • HTN
  • HF
  • diabetic nephropathy
  • MI
  • Stroke prevention
  • prevention of MI, stroke, and death in those with high CV risk
  • diabetic retinopathy
70
Q

adverse effects for ARBs (8)

A
  • hyperkalemia
  • fatigue, headache, dizziness
  • insomnia
  • sinus congestion
  • angioedema
  • renal failure
  • lower incidence of cough bc ARBs don’t affect bradykinin*
71
Q

contraindications for ARBs (3)

A
  1. Pregnancy
  2. Bilateral renal artery stenosis (or stenosis in artery to single remaining kidney)
  3. History of hypersensitivity reactions (especially angioedema) to ARBs
72
Q

monitoring for ARBs (3)

A
  • monitor for reduced BP (140/90)
  • monitor for reduced s/s HF
  • monitor for protienuria & GFR
73
Q

important drug interaction for ARBs

A

hypotensive effects of ARBs are additive with those of other antihypertensive drugs…when ARB is added, other drugs may require reduction

74
Q

use cautiously in patients with HF, liver impairment or patients taking digoxin or beta blockers (2)

A

verapamil & diltizem

75
Q

3 classes of CCBs

A
  1. diphenyalkylamines
  2. benzothiazipines
  3. dihydropyridine
76
Q

diphenyalkylamines

A

verapamil

77
Q

benzothiazipines

A

diltiazem

78
Q

dihydropyridines

A

nifedipine

79
Q

agent that affects the heart & blood Vessels

A

verapamil

80
Q

agent that act maiNly on blood vessels

A

nifedipine

81
Q

prototype CCBs (2)

A

verapamil & nifedipine

82
Q

therapeutic uses for verapamil (3)

A
  • angina
  • essential HTN (2nd line)
  • cardiac dysrhythmias
83
Q

contraindications for verapamil & diltiazem (3)

A
  • severe hypotension
  • sick sinus syndrom
  • second or third degree AV block
84
Q

adverse effects include: cardiosuppression (brady, AV block, & HF), peripheral edema, and constipation*

A

verapamil (and diltiazem)

85
Q

drug interactions include: digoxin, beta blockers, and grapefruit juice

A

verapamil (and diltiazem)

86
Q

which medication class should be used cautiously with hypotension, sick sinus syndrome, second/third degree AV block, angina (d/t RT), and HF?

A

nifedipine

dihydropyridines

87
Q

which drug can treat angina and essential HTN?

A

nifedipine

88
Q

reflex tachycardia, gingival hyperplasia, eczema, & peripheral edema are adverse reactions of what drug?

A

nifedipine

89
Q

positive drug interaction associated with nifedipine

A

beta blockers (to prevent reflex tachycardia)

90
Q

how do beta blockers interact with nifedipine?

how they interact with verapamil & diltiazem?

A 
nifed = decreases cardiac affects
verapamil = intensify adverse effects
91
Q

which CCBs can worsen HF & cause bradycardia?

A

verapamil & diltiazem

92
Q

which CCB is associated with constipation

A

verapamil

93
Q

which CCB has an increased risk of MI when used for HTN?

A

nifedipine

NU 607 Pharm Quiz 2 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions