Drugs unique properties, contraindications, test fodder

Question 1

Stress response, angiotensin II, increase osmolality, hypovolemia trigger release of?

Answer 1

ADH

Question 2

side effect of av block and bradyarrhythmia

Answer 2

Propranolol (Inderal, Innopran)Metoprolol (Lopressor, Toprol); atenolol (Tenormin)

Question 3

side effects include Hypocalcemia, hypomagnesemia, metabolic alkalosis, hypokalemia, ototoxicity

Answer 3

Furosemide (Lasix), Bumetanide (Bumex)

Question 4

why is labetalol contraindicated for diabetics?

Answer 4

B₂ blockade will prevent glycogenolysis and gluconeogenesis: important in diabetic and leads to hypoglycemia

Question 5

aldosterone causes what effects on the kidney

Answer 5

Act on kidney to:

• Sodium retention
• Water retention
• Potassium excretion
• H⁺ excretion

Question 6

Contraindicated: CHF, pulmonary edema, intracranial bleeding, severe renal disease with anuria

Answer 6

Mannitol, isosorbide

Question 7

The Active metabolite is a full V1 agonist and half life is 4-6 hours?

Answer 7

Terlipressin

Question 8

Therapeutic effects in the treatment of heart failure to reduce or reverse pathological cardiac hypertrophy and B receptor desensitization

Answer 8

Propranolol (Inderal, Innopran)Metoprolol (Lopressor, Toprol); atenolol (Tenormin)

Question 9

used to treat Malignant hypertension, volume-based hypertension with chronic kidney disease

Answer 9

Furosemide (Lasix), Bumetanide (Bumex)

Question 10

used to treat Hyperuricemia or gout, Acute mountain sickness (altitude sickness)

Answer 10

Acetazolamide (Diamox)

Question 11

Released when low blood volume levels the ___________

Answer 11

Angiotensin II

Question 12

side effects of Metabolic acidosis, urinary alkalinization, high levels of bicarbonate excreted

Answer 12

Acetazolamide (Diamox)

Question 13

side effects include Electrolyte imbalance, pulmonary edema by increasing plasma oncotic pressure and increasing preload

Answer 13

Mannitol, isosorbide

Question 14

side effects include Hyperglycemia (unclear mechanism), hypokalemia, metabolic alkalosis

Answer 14

Hydrochlorothiazide (HCTZ), chlorothiazide (Diuril)

Question 15

Could be used to treat?

esophageal varies, portal hypertension

central (neurohypophyseal) diabetes insipidus- NOT nephrogenic, bleeding disorders

Answer 15

Vasopressin (AVP/pitressin

V1: esophageal varies, portal hypertension

V2: central (neurohypophyseal) diabetes insipidus- NOT nephrogenic, bleeding disorders

Question 16

used to treat Secondary hypertension caused by hyperaldosteronism

Answer 16

Spironolactone (Aldactone), eplerenone (inspra)

Question 17

What two CCB are dihydropyridines?

What channel conformation do they prefer?

What is the advantage?

Answer 17

nifedipine/Procardia

amlodipine/Norvasc

dihydropyridines prefer the inactivated L type channel

vasodilation

Question 18

Angiotensin 2 causes what effects?

Answer 18

Thirst, ADH release, aldosterone secretion, Na⁺ reabsorption from PCT, renal vasoconstriction on efferent arteriole, release catecholamines, vasoconstriction

Question 19

Inhibition of Na⁺ reabsorption in thick ascending Loop of Henle by blocking NKCC2 (Na⁺/K⁺/Cl^-) transporter

Answer 19

Furosemide (Lasix), Bumetanide (Bumex)

Question 20

diuretic Contraindicated: sulfa drug allergy

Answer 20

Furosemide (Lasix), Bumetanide (Bumex)

Question 21

excess aldosterone would lead to?

Answer 21

Excess: hypokalemia, alkalosis, hypertension

Question 22

does desmopressin have a long or short half life?

Answer 22

long

Question 23

could be used to treat Post-lumbar puncture headache,

Central (neurohypophyseal) diabetes insipidus, bleeding disorders

Answer 23

Desmopressin (DDAVP)

Question 24

Pharmacological blockage of ENaC Na⁺ channel (not synthesis of the channel like Spironolactone)

Answer 24

amiloride, triamterene,

Question 25

used to treat Liddle’s syndrome: gain of function mutation of Na⁺ channels

Answer 25

**amiloride, triamterene,**

Question 26

Synthesized in adrenal cortex response to elevated potassium and angiotensin II

Answer 26

aldosterone

Question 27

B2 blockade for propranolol can cause?

Answer 27

bronchospasm/constriction, diabetics

Question 28

used for treatment of Rapid treatment of increased intracranial pressure (trauma, cerebral edema, tumor)

Answer 28

**Mannitol, isosorbide**

Question 29

insufficient aldosterone would lead to?

Answer 29

Insufficient: hyperkalemia, acidosis, hypotension

Question 30

Contraindicated: ACE and ARBs (**potassium sparing**), chronic renal insufficiency susceptible to hyperkalemia

Answer 30

**Spironolactone (Aldactone), eplerenone (inspra)****amiloride, triamterene,**

Question 31

side effects of AV block, bradyarrhythmia, bronchospasm

Answer 31

**Labetalol (Trandate)**

Question 32

CCB that prefer open confirmation L type calcium channel

Answer 32

verapamil/Covera-HS diltiazem/Cardizem

Question 33

Hypertension; preferred first line for African Americans

Answer 33

**Hydrochlorothiazide (HCTZ), chlorothiazide (Diuril)**

Question 34

side effect of kidney stones

Answer 34

**triamterene,**

Question 35

used to treat Preload reduction in the treatment of heart failure, SIADH

Answer 35

**Conivaptan**

Question 36

a side effect of **Desmopressin (DDAVP)**

Answer 36

V2: water intoxication

Question 37

side effects include Hyperkalemia, metabolic acidosis, impotence

Answer 37

**Spironolactone (Aldactone),**

Question 38

the only endogenous diuretic

Answer 38

natriuretic peptides

Question 39

side effect of ischemia, gangrene, anginal pain, myocardial ischemia, facial pallor

Answer 39

* Antidiuretic Hormone (ADH) • Vasopressin (AVP/pitressin) * Terlipressin V1: anginal pain, myocardial ischemia, facial pallor

Question 40

osmotics like **Acetazolamide (Diamox) and** **Mannitol, isosorbide are not used for?**

Answer 40

long term treatment