Diuretics and Anti-hypertensives Flashcards
Name 2 K+-Sparing diuretics.
- Spironolactone
- eplerenone
Blood pressure is the product of _____ and _____.
cardiac output (C.O.) and peripheral vascular resistance (P.V.R.)
What is Acetazolamide?
a carbonic anhydrase inhibitor that acts as a diuretic
How do thiazide diuretics work?
inhibit the Na+/Cl- cotransporter in the distal convoluted tubule, causing moderate diuresis
What is the main unique SE of Spironolactone?
gynecomastia
What do ACE inhibitors treat?
- HTN
- HF
- CKD
- diabetic nephropathy
What are the adverse side effects of ARBs?
- hyperkalemia
- contraindicated in pregnancy
- mild increase in SCr
- angioedema (rare)
- anemia (rare)
When is mannitol used?
- to prevent acute kidney injury in glaucoma
- in elevated intracranial pressure
Name 4 loop diuretics.
- Furosemide
- bumetanide
- torsemide
- ethacrynic acid
What part of the nephron is responsible for reabsorption of 70-80% of all water, electrolytes, short peptides, and other small molecules in the plasma ultrafiltrate?
the proximal convoluted tubule (PCT)
Where do the K+-Sparing Diuretics act upon?
the distal convoluted tubule and the collecting duct
Acetazolamide can induce ______.
metabolic acidosis
How do the K+ sparing diuretics work?
they are aldosterone antagonists
Name 3 thiazide diuretics.
- HCTZ
- chlorthalidone
- metolazone
How do ACE inhibitors work?
- block the conversion of ATI to ATII
- block the degradation of bradykinin
How do beta blockers work?
compete with catecholamines at peripheral adrenergic neuron site
What is the onset of action of an ACE inhibitor?
rapid
What do beta blockers do?
- decrease cardiac output
- suppress renin activity
What are some adverse effects of ACE inhibitors?
- cough
- hyperkalemia
- contraindicated in pregnancy
- mild increase in SCr
- angioedema (rare)
- anemia (rare)
What are loop diuretics used for?
- Pulmonary edema
- edema caused by cardiovascular, renal, hepatic disease
- hypercalcemia
What is mannitol?
a sugar that is not metabolized and not reabsorbed, thereby acting as a diuretic
How do ARBs work?
irreversibly block the action of Angiotensin II at the AT1 receptor
When is Acetazolamide used?
- Glaucoma
- metabolic alkalosis
- mountain sickness
How does mannitol act as a diuretic?
it elevates the osmoarity of the glomerular filtrate to hinder the reabsorption of water
How does Acetazolamide work?
it inhibits the regeneration of bicarbonate in the proximal tubule
Name 2 sodium channel blockers.
- Triamterene
- Amiloride
How do Ca++ channel blockers work?
- cause arterial vasodilation
- lower the peripheral vascular resistance by blocking L-type Ca++ channels
What do ACE inhibitors end in?
-pril
What is the difference between a dihydropyridine (DHP) and a non-dihydropyridine (Non-DHP)?
- DHPs are more selective at blocking L-type Ca++ channels
- Non-DHPs decrease conduction through the AV node
______ is a drug that can induce a metabolic acidosis.
Acetazolamide
How do loop diuretics work?
inhibit Na+/K+/2Cl- transporter
What are dihydropyridines (DHPs) and non-dihydropyridines (NDHPs)?
Ca++ channel blockers
What is the main unique SE of loop diuretics?
Hearing loss (ototoxicity)
What is the macula densa?
- a group of specialized cells located at the distal part of the loop of Henle which are in contact with the afferent arteriole
- regulates renin secretion
What do ARBs end in?
-sartan
What drugs cause arterial vasodilation and lower peripheral vascular resistance by blocking L-type Ca++ channels?
Ca++ channel blockers
What do ARBs treat?
- HTN
- HF
- CKD
- diabetic nephropathy
How does aldosterone enhance the tubular reabsorption of Na?
it stimulates the synthesis and translocation of Na transporter proteins
Name 2 non-dihydropyridines (NDHPs).
- diltiazem
- verapamil
This is a group of specialized cells located at the distal part of the loop of Henle which are in contact with the afferent arteriole regulates renin secretion.
the macula densa
Where do the thiazide diuretics act upon?
the distal convoluted tubule
These drugs inhibit the Na+/Cl- cotransporter in the distal convoluted tubule, causing moderate diuresis
thiazide diuretics
How do sodium channel blockers work?
- block luminal sodium channels and decrease the driving force for potassium secretion/excretion
- indirectly decrease hydrogen ion secretion
What do the dihydropyridines end in?
-pine
