Diuretics and RAAS antagonists II

Question 1

Effect of diuretic agents on plasma electrolytes:
Which class reduce K+ (hypokalemia)?
________
Which one increase K+?

Answer 1

1. Loop
2. Thiazide
3. Loop + Thiazide
   ____________
4. Aldo antag

Question 2

Hypokalemia adverse effects

Answer 2

can result in weakness, paresthesias, cardiac sensitization (predisposition to ectopic pacemakers),

thus use not advisable in patients with arrhythmias, history of myocardial infarction, pre-infarction angina

Question 3

Effect of diuretic agents on plasma electrolytes:
Which class increases Urate?

Answer 3

1. Loop
2. Thiazide
3. Loop + Thiazide

Question 4

Effect of diuretic agents on plasma electrolytes:
Which class reduces Ca2+ ?

Answer 4

Loop

Question 5

Effect of diuretic agents on plasma electrolytes:
Which class reduces Mg2+ ?

Answer 5

Loop

Question 6

Effect of diuretic agents on plasma electrolytes:
Which class increases Ca2+ ?

Answer 6

Thiazide

Question 7

NaCl reabsorption occurs out of which part of the renal tubule?

Answer 7

Distal convoluted tubule

Question 8

Thiazides increase _________ of Ca++ ( NOTE: loop diuretics ______ serum Ca++ levels)

Answer 8

reabsorption

decrease

Question 9

Which drugs can ppt a gout attack?

Answer 9

thiazide diuretics

Question 10

Which drugs are most efficacious in HF? Which drugs are infrequently used in HF?

Answer 10

Loop diuretics

Thiazides

Question 11

True/False: Triamterene and Amiloride block pro-fibrotic actions of aldosterone

Answer 11

False: no utility in HF

Question 12

Adverse rxn of K+ sparing diuretics

Answer 12

Hyperkalemia–> EKG changes, conduction abnormalities, arrhythmias.

Question 13

Types of drugs that are anti-remodeling with Decreased:
Hypertrophy
Fibrosis
Apoptosis

Answer 13

1. ACE INHIBITORS / ANGIOTENSIN RECEPTOR BLOCKERS
2. BETA BLOCKERS
3. ALDOSTERONE RECEPTOR BLOCKADE
   - All 3 REDUCE MORBIDITYAND IMPROVE SURVIVAL

Question 14

ACEI potential side effects

Answer 14

+ bradykinin –> chronic dry cough

• hypotension
• plasma K+ increase
• contraindicated in pregnancy (just like ARBs)