Drugs to Treat Hypo/Hyperkalemia (Wolff)

Question 1

What factors enhance cell uptake of potassium?

Answer 1

1) Insulin
2) β-Catecholamines
3) Alkalosis

Question 2

What factors decrease cell uptake of potassium?

Answer 2

1) α-Catecholamines

2) Acidosis

Question 3

What make up the K+ sparing diuretics?

Answer 3

1) Triamterene
2) Amiloride
3) Spironolactone

Question 4

What make up the K+ losing diuretics?

Answer 4

1) Thiazides

2) Loop diuretics

Question 5

What is the general MOA of triamterene and amiloride?

MOA of Spironolactone?

Answer 5

1) Na+ channel blockers

2) Aldosterone antagonist

Question 6

What is the general MOA of thiazides?

Of loop diuretics?

Answer 6

1) Na+ Cl- cotransporter blockers

2) Na+ K+ 2Cl- cotransporter blockers

Question 7

What are common clinical reasons for administering diuretics?

Answer 7

1) Essential HTN

2) Edema from kidney failure

Question 8

Where do the loop diuretics act on?

Where do the thiazide diuretics act on?

Where do the Sodium channel blockers and spironolactone act on?

Answer 8

1) Thick ascending limb of Henle
2) Distal convoluted tubule
3) Collecting duct

Question 9

Which K+ losing diuretic works in patients with low GFR?

Answer 9

Loop diuretics

Question 10

What are the loop diuretics?

Answer 10

1) furosemide
2) torsemide
3) bumetanide
4) ethacrynic acid

Question 11

Why do the loop diuretics (besides ethacrynic acid) and thiazides have a risk of hypersensitivity?

Answer 11

Contains sulfonamide (sulfa allergy)

Question 12

What is the overall MOA of loop diuretics?

Answer 12

Block the Na+-K+-2Cl- cotransporter in the thick ascending limb

Question 13

What is the overall MOA of thiazides?

Answer 13

Block the Na-Cl cotransporter in the distal

convoluted tubule

Question 14

What toxicities in regards to ion levels are noted with loop diuretics and thiazides?

Answer 14

1) Hypokalemia
2) Hyponatremia
3) Hypocalcemia
4) Hypomagnesemia
5) Hypochloremic metabolic alkalosis

Question 15

What is the overall MOA of amiloride?

Answer 15

Blocks epithelial sodium channels (ENaC) in the collecting ducts

Question 16

What is the clinical application of amiloride?

Answer 16

Counteracts K+ loss induced by other diuretics

Question 17

What is the overall MOA of spronolactone?

Answer 17

Competitive antagonist of aldosterone receptors in the collecting ducts

Question 18

Why does spironolactone have slow on and slow off effects?

Answer 18

Because it’s a steroid

Question 19

What toxicity is noted with amiloride and spironolactone?

Answer 19

Hyperkalemia

Question 20

What is the mainstay treatment of hypokalemia?

Answer 20

K+ replacement

Question 21

What can be given as intravenous K+ replacement?

It is usually reserved for?

Answer 21

1) Potassium chloride and potassium acetate if acidosis

2) Severe hypokalemia

Question 22

What can be given as oral K+ replacement?

Answer 22

1) Potassium chloride
2) Potassium phosphate
3) Potassium bicarbonate

Question 23

In the emergency treatment of hyperkalemia, what do you give in order to antagonize cardiac effects?

Answer 23

IV calcium

Question 24

In the emergency treatment of hyperkalemia, what do you give in order to redistribute K+ into cells?

Answer 24

1) Insulin
2) Glucose
3) Albuterol

Question 25

In the emergency treatment of hyperkalemia, what do you give in order to facilitate K+ elimination?

Answer 25

1) K+ losing diuretic

2) Mineralocorticoid in patients with hypoaldosteronism