Drugs with Therapeutic Effects on Renal Function

Question 1

what do diuretic do

Answer 1

increase excretion of sodium and chloride ions and water from the renal tubules
this increases urinary flow

Question 2

indications of diuretics

Answer 2

conditions where there is excess accumulation of water and sodium in the body
e.g. heart failure, liver failure, renal failure, hypertesion

Question 3

what are the five types of diuretic

Answer 3

loop
thiazide and thiazide type
potassium sparing
osmotic
carbonic anhydrase inhibitor

Question 4

2 examples of loop diuretics

Answer 4

furosemide
bumetanide

Question 5

where do loop diuretics act

Answer 5

thick ascending limb of LoH

Question 6

give 2 examples of thiazide/-type diuretics

Answer 6

bendroflumethiazide, chlortalidone

Question 7

where do thiazide diuretics work

Answer 7

DCT

Question 8

give 2 examples of potassium sparing diuretics

Answer 8

sprionolactone
amiloride

Question 9

what is the MoA of potassium sparing diuretics

Answer 9

inhibit reabsorption of 2-3% of sodium ions in exchange for potassium or hydrogen ions in

Question 10

when are osmotic diuretics used

Answer 10

to treat cerebral oedema in intensive care occasionally

Question 11

example of osmotic diuretic

Answer 11

mannitol

Question 12

MoA of osmotic diuretic

Answer 12

filtered at glomerulus
not reabsorbed
so exert osmotic pressure
which prevents water reabsorbtion

Question 13

name of carbonic anhydrase inhibitor

Answer 13

acetazolamide

Question 14

indications of acetazolamide

Answer 14

prevent acute altitude sickness
glaucoma management
occasionally as mild diuretic

Question 15

MoA of acetazolamide

Answer 15

reduces production of hydrogen and bicarbonate ions which are necessary for a proportion of reabsorption of soidum and chloride ions in the PCT

Question 16

difference in MoA of ACEi vs. ARBs

Answer 16

ACEi - inhibit production of angiotensin II
ARB - block action of angiotensin II at its receptor

Question 17

indications and contraindication of ARBs and ACEis

Answer 17

hypertension and heart failure
not primary renal disease

Question 18

what drugs act on the PCT

Answer 18

SLGT-2 inhibitors
uricosuric drugs

Question 19

MoA of SLGT-2 inhibitors

Answer 19

inhibits co-transporter that reabsorbs glucose with sodium which increases urinary excretion of glucose

Question 20

indication of SLGT-2 inhibitors

Answer 20

type 2 diabetes

Question 21

indications of uricosuric drugs

Answer 21

long term prevention of gout

Question 22

MoA of uricosuric drugs

Answer 22

block reabsorption of uric acid in PCT

Question 23

where does synthetic parathyroid hormone act

Answer 23

DCT

Question 24

indication of synthetic PTH

Answer 24

to maintain reabsorption and calcium concentration in patients with chronic hypoparathyroidism

Question 25

what drugs act on the collecting duct

Answer 25

vasopressin analogues and inhibitors

Question 26

name of vasopressin analogue

Answer 26

desmopressin

Question 27

indication of desmopressin

Answer 27

diabetes insipidus - those who can't make vasopressin so become dehydrated

Question 28

indication of vasopressin inhibitors

Answer 28

excessive secretion of vasopressin due to tumour or drugs - SIADH

Question 29

what is demeclocycline and what is its MoA

Answer 29

an antibiotic which inhibits the responsiveness of the collecting duct cells to vasopressin and reduces water reabsorption when fluid restriction alone has been ineffective

Question 30

what is tolvaptan and its MoA

Answer 30

vasopressin V2 receptor antagonist which reduces water reabsorption

Question 31

what are epoetins

Answer 31

recombinant human erythropoetins

Question 32

indication of epoetins

Answer 32

used to treat anaemia associated with erythropoetin difficeincy in chronic renal failure

Question 33

indication of hydroxylated forms of vitamin D (alfacalcidol and calcitriol)

Answer 33

severe renal impairment where the kidneys can't hydroxylate vitamin D themsleves

Question 34

indication of sodium bicarbonate

Answer 34

those with advanced renal impairment who develop metabolic acidosis as they are not reabsorbing sodium bicarbonate in their PCTs