FINISH Renal pharmacology

Question 1

Renin

Answer 1

-

Question 2

Angiotensin II

Answer 2

-

Question 3

Angiotensin III

Answer 3

-

Question 4

ADH aka vasopressin aka arginine vasopressin (AVP)

Answer 4

-

Question 5

Loop diuretics

Answer 5

Act on loop of Henle
V powerful action - rate of diuresis up to 4L/day.
Effect reduced on repeated administration.
Continues administration can lead to hypokalaemia & corresponding metabolic alkalosis.
Large reduction in fluid volume can be achieved- v useful in acute heart failure.
Some inhibition of carbonic anhydrase

Question 6

Furosemide

Answer 6

Loop diuretic
Blocks Na+-K+-2Cl- co-transport in apical (luminal) membrane of cells of thick ascending limb.
Given intravenously acts in ~10mins (precedes diuresis- probably due to causing venodilation), given orally has effects in 1-1.5hrs.

Venodilator mechanism also increases effects on the nephron by increasing renal blood flow without a change in GFR (i.e by decreasing the fraction of blood flow filtered at the glomerulus)

Question 7

Bumetanide

Answer 7

Loop diuretic

Question 8

Thiazide diuretics

Answer 8

-

Question 9

Hydrochlorothiazide

Answer 9

Thiazide diuretic

Question 10

Benzoflumethazide

Answer 10

Thiazide diuretic

Question 11

Potassium sparing diuretics

Answer 11

-

Question 12

Amiloride

Answer 12

Potassium-sparing diuretic

Question 13

Triamterene

Answer 13

Potassium- sparing diuretic

Question 14

Sprironolactone

Answer 14

Potassium sparing diuretic

Question 15

Canerone

Answer 15

Product of spironolactone metabolism in the liver. Thought to be responsible for some of the effects of spironolactone.

Question 16

Potassium canrenoate

Answer 16

Potassium salt of canerone

Works as a potassium-sparing diuretic

Question 17

Acetozolamide

Answer 17

Carbonic anhydrase inhibitor

Question 18

Carbonic anhydrase inhibitors

Answer 18

-

Question 19

Osmotic diuretics

Answer 19

-

Question 20

Mannitol

Answer 20

Osmotic diuretic

Question 21

Captopril

Answer 21

ACE inhibitor

Question 22

Enalapril

Answer 22

ACE inhibitor

Inactive. Converted in the liver -> active metabolite enalaprilat

Question 23

Losartan

Answer 23

Non-peptide angiotensin II receptor (AT1 not AT2) antagonist (an ARB)

Question 24

Probecenid

Answer 24

Treatment for gout
Competes for the same carrier as uric acid in the proximal tubule- thereby inhibits uric acid reabsorption.

(Symptoms of gout result from excessive production of purines leading to deposition of sodium urate crystals in the synovial tissue of joints)

Question 25

Saralasin

Answer 25

Angiotensin II partial agonist.

Peptide- not suitable for oral administration (thus not really competitive with other antihypertensive drugs)