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CRRAB II (Elaina) > Diuretics & PBL Drugs > Flashcards

Diuretics & PBL Drugs Flashcards

1
Q

Acetazolamide MOA/location/main AE

A

Carbonic Anhydrase inhibitor
PCT
NaHCO3 excretion, loss of HCO3 –> Causes acidosis

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2
Q

Mannitol MOA/location

A

Osmotic diuretic: inc. tubular fluid osmolarity –> pull water into tubule –> inc. urine flow
PCT

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3
Q

Loop diuretics MOA/location

A

Inhibit NKCC (N, K, 2Cl)
Thick ascending limb of LOH
Cannot reabsorb Na, 2Cl back –> do not hyperconcentrate medulla insterstitium–> water doesn’t follow –> excrete more urine
Stimulate PGE release –> vasodilate afferent arteriole –> inc. GFR –> excrete more urine
Inc. Ca++ excretion (don’t have Na+ to power reabsorption)

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4
Q

loop diuretics adverse effects

A 
OH DANG!
Ototoxicity
Hypokalemia
Dehydration
Allergy (sulfa)
Nephritis (interstitial)
Gout
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5
Q

thiazide diuretics names

A

chlorthalidone, hydrochlorothiazide

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6
Q

thiazides MOA/location

A

inhibit NaCl reabsorption in early DCT –> decrease diluting capacity of nephron
Decrease Ca++ excretion

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7
Q

thiazides AE

A

Hypokalemia, metabolic acidosis, hyponatremia, hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia, sulfa allergy

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8
Q

K+ sparing diuretics examples

A

spironolactone, eplerenone

triamterine, amiloride

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9
Q

spironolactone, eplerenone MOA and location

A

competitive aldosterone receptor antagonists in cortical collecting duct

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10
Q

triamterine amiloride MOA and location

A

Block Na+ channels in cortical collecting duct

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11
Q

K+ sparing diuretics AE

A

Hyperkalemia –> arrhythmias

endocrine effects w/ spironolactone

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12
Q

When use TMP-SMX

A

acute cystitis when resistance rates < 20% and not used in last 3 months
first line female (and uncomplicated male - but usually have prostatitis, then use fluoros)

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13
Q

when use nitrofurantoin

A

first line female (w/ bactrim) - do NOT use in pyelonephritis

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14
Q

concerns with using fluroquinolones in UTI

A

Resistance, broad spectrum –> C diff

Tendon rupture

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15
Q

MEchanism for thiazides to decrease BP

A

decrease blood volume AND decrease resistance (major method) - open K+ channels –> increase K+ –> decrease Ca++ in smooth muscle –> decrease contraction

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16
Q

mechanism for thiazides to cause hyperglycemia

A

suppress insulin release (sulfonylureas) - bind SUR on K channel controlling insulin release - open channel, hyperpolarize cell

17
Q

loop diuretics names

A

furosemide, bumetanide

18
Q

thiazide diuretics names

A

chlorthalidone, hydrochlorothiazide, metalazone

19
Q

diuretics used to decrease kidney stones

A

thiazides (hypouricuria, hyperuricemia though)

20
Q

K+ sparing diuretics - aldosterone inhibitors names

A

spironolactone, epleronone

21
Q

K+ sparing diuretics - inhibit Na/K/H exchange - names

A

amiloride

triamterene

22
Q

ADH name and its congener

A 
Vasopressin = natural hormone
Desmopressin = synthetic congener
23
Q

indications ADH

A

central DI

bedwetting

24
Q

abx w/ some activity as an ADH antagonist

A

Demecocycline

- would act as an ADH diuretic

25
Q

allopurinol MOA

A

blocks formation of uric acid by inhibiting xanthine oxidase (for gout)

26
Q

probenacid, sulfinpyrazone MOA

A

inhibits renal organic acid transporter to facilitate excretion of uric acid –> reduce gout risk

27
Q

colchicine MOA

A

microtubule inhibitor with anti-inflammatory properties

28
Q

4 types of insulin

A

ultra-rapid (fast-acting)
regular
nph (intermediate)
long-acting (glargine)

29
Q

names of fast-acting insulin

A

insulin aspart
***insulin lispro
insulin glulisine

“ultra-rapid”

30
Q

NPH human insulin =

A

intermediate acting

31
Q

names of long-lasting insulin

A

insulin glargine

insulin detemir

32
Q

why insulin lispro so fast

A

quickly dissociates from hexamer form to monomers which are active at IR

33
Q

why insulin glargine long lasting

A

insoluble so forms micro-precipitates which release constant amounts of insulin to give constant blood level

34
Q

ultra-rapid insulin onset, peak, duration

A

15 min
2 hours
4 hours

35
Q

regular insulin onset, peak, duration

A

30 min
3 hours
6 hours

36
Q

NPH insulin onset, peak, duration

A

2 hours
6.5 hours
17 hours

37
Q

insulin glargine onset, peak, duration

A

1.5 hours
9 hours
22 hours

CRRAB II (Elaina) (7 decks)

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