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2 - CPR (renal) > Drugs for Hypo/Hyperkalemia > Flashcards

Drugs for Hypo/Hyperkalemia Flashcards

1
Q

What defines Hyperkalemia?

A

Plasma [K+] > 5.2

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2
Q

What defines Hypokalemia?

A

Plasma [K+] < 3.7

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3
Q

Is K+ usually inside or outside of the cell?

A

Inside

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4
Q

If K+ is outside of the cell, then it will be?

A

Hyperkalemia

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5
Q

What things cause K+ to go inside the cell, thus causing more hypokalemic actions?

A

Insulin
Beta2 Agonists
Alpha Antagonists
Aldosterone deficiency

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6
Q

What classes of drugs are K+ sparing diuretics?

A

Aldosterone Antagonists

Na+ channel blockers

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7
Q

Where do K+ sparing diuretics act?

A

Cortical Collecting Duct

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8
Q

What classes of drugs are K+ losing diuretics?

A

Loops
Thiazides
Carbonic Anhydrase (-)’s
Osmotic diuretics

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9
Q

MOA for Thiazides and where do they act?

A

Block Na+ Cl- channels

– act at distal convoluted tubule

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10
Q

MOA for Loops and where do they act?

A

Block Na+ K+ 2Cl- channels

– act at thick ascending limb

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11
Q

Carbonic Anhydrase (-)’s and Osmotic Diuretics are used less often, but where do they act?

A

Proximal tubule and thin descending limb

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12
Q

What are 2 reasons to give Diuretics?

A

HTN

Edema due to heart/kidney/liver failure

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13
Q

What are the 4 loops?

A

Furosemide
Torsemide
Bumetanide
Ethacrynic Acid

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14
Q

Loops work in patients with _____ unlike Thiazides

A

Low GFR

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15
Q

Loops and Thiazides should not be used in patients with an allergy to?

A

Sulfa

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16
Q

Which Loop can be used in patients with a sulfa allergy?

A

Ethacrynic Acid

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17
Q

What is a possible side effect of Furosemide?

A

Ototoxicity

18
Q

Which loop has a longer half life, better oral absorption and works better in HF?

A

Torsemide

19
Q

Which loop has more predictable oral absorption?

A

Bumetanide

20
Q

What are the 4 Thiazides?

A

HCTZ
Chlorothiazide
Chlorthalidone
Metolazone

21
Q

Which Thiazide has poor oral absorption?

A

Chlorothiazide

22
Q

Which Thiazide has a half life of 40-60 hours and is preferred by some HTN specialists?

A

Chlorthalidone

23
Q

Which Thiazide is preferred with CHF?

A

Metolazone

24
Q

Why do Thiazides cause Hypercalcemia?

A

More reabsorption in proximal tubule due to volume contraction

25
Q

Between loops and thiazides, which cause more Magnesium loss?

A

Thiazides

26
Q

What are the Na+ channel blockers?

A

Triamterene

Amiloride

27
Q

What are the Aldosterone Antagonists?

A

Spironolactone

Eplerenone

28
Q

What is a possible side effect of the K+ sparing diuretics?

A

(Na+ channel blockers and Aldosterone antagonists)

= Hyperkalemia

29
Q

Spironolactone is also a ____ which can cause?

A

Partial agonist at androgen receptors

=> Amenorrhea, Hirsutism, Gynecomastia

30
Q

What can Spironolactone decrease with post-MI heart failure?

A

Decreases Fibrosis on the heart

31
Q

Which Aldosterone Antagonist is more selective?

A

Eplerenone

32
Q

What are the symptoms of Hypokalemia?

A

Lethargic, Lots of urine output, arrhythmias, cramps, low BP

33
Q

What is the treatment for Hypokalemia?

A

K+ replacement

34
Q

IV K+ replacement is used with severe Hypokalemia. What kind is used and how fast?

A

K+ chloride/acetate – 10-20 mEq/hr

35
Q

Oral K+ replacement should be taken with water to prevent?

A

GI irritation

36
Q

What are the symptoms of Hyperkalemia?

A

Bradycardia, low urine output, numb, weak, paralysis

37
Q

What are the ECG changes with Hyperkalemia?

A

Peaked T wave and Widened QRS

38
Q

What are the 3 steps to treating Hyperkalemia?

A
  1. Antagonist cardiac effects
  2. Redistribute K+ into cells
  3. Facilitate K+ loss
39
Q

With Hyperkalemia, how do you antagonist cardiac effects?

A

Give IV calcium

40
Q

With Hyperkalemia, how do you redistribute K+ into the cells?

A

Give Insulin, Glucose or Beta2 agonists

41
Q

With Hyperkalemia, how do you facilitate K+ loss?

A

Give K+ losing diuretics, mineralcorticoids or dialysis

42
Q

If there is Acidosis, what is the level of K+ usually?

A

Hyperkalemia

2 - CPR (renal) (27 decks)

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