Diuretics, hypertension drugs and heart failure drugs:

Question 1

carbonic anhydrase inhibitors (acetazolamide)

Answer 1

reduces H available for NHE.

Question 2

osmotic agents (mannitol)

Answer 2

increases osmolarity of filtrate, so more fluid lost.

Question 3

loop diuretics (furosemide)

Answer 3

inhibit NKCC2 in TAL.

Question 4

thiazide diuretics (bendrofumethiazide)

Answer 4

inhibits NCC in DCT.

Question 5

Amiloride

Answer 5

ENac inhibitor

Question 6

Spironolactone

Answer 6

aldosterone antagonist.

Question 7

ACEi (ramipril)

Answer 7

inhibits conversion of angiotensin 1 to angiotensin 2. Potentiates action of bradykinin, causing a build up.

Question 8

angiotensin receptor inhibitor (losartan)

Answer 8

blocks receptor, thus no effects of sympathetic nervous system, no ADH secretion and no aldosterone excretion.

Question 9

Give the three groups of calcium channel blockers used in hypertension and for each one list an example.

Answer 9

dihydropyridine- amlodipine
benzothiazepines- diltiazem- good at dilating coronary vessels.
phenylalkylamines- verapamil

Question 10

alpha blockers (doxazosin)

Answer 10

blocks alpha-1 receptors, thus blocking NA effects on vascular smooth muscles, hence reducing peripheral resistance.

Question 11

beta blockers

Answer 11

block sympathetic innervation of the heart, thus reducing chronotropy and inotropy and also inhibits renin release.

Question 12

GTN spray

Answer 12

prodrug which produces nitric oxide which increases levels of cGMP and stimulates dephosphorylation of myosin, so the smooth muscle cells in walls of blood vessels relax.

Question 13

what do you prescribe for heart failure?

Answer 13

ACEi or ARB and a beta blocker. Loop or thiazide diuretic can be added if needed for symptom relief of oedema.