HY Renal Pharm

Question 1

loop diuretics

Answer 1

• reduce intravascular volume
• Block Na/K/2Cl transporter in ascending LOH
• very potent
• good for CHF
• bad for HTN
• side fx: hypokalemia, hypochloremia, metabolic alkalosis

Question 2

thiazide diuretics

Answer 2

• reduce intravascular volume
• block Na/Cl pump in DCT
• lower potency
• good for essential HTN

Question 3

K+ sparing diuretics

Answer 3

• reduce intravascular volume
• block aldo receptors
• lower potency
• good to combine with others

Question 4

nitrates

Answer 4

• decrease venous tone (lowers preload)
• decrease arterial tone (lowers afterload)
• increase [cGMP] to promote relaxation of smooth muscle

Question 5

Ca blocker (in smooth muscle)

Answer 5

• decrease venous tone (reduce preload)
• block Ca entry into cell, MLCK not activated, prevent sm muscle contraction
• side fx: peripheral edema from venous pooling

Question 6

beta blocker

Answer 6

• reduce heart rate
• block B1 receptor, less Ca enters SA node, decrease contraction
• if nonselective: bronchoconstriction

Question 7

Ca blocker (in cardiac muscle)

Answer 7

• reduce HR

- directly block Ca entry into SA node, decrease contraction

Question 8

alpha 2 agonists

Answer 8

• decrease arterial tone (reduce afterload) thru SNS
• in CENTRAL NS
• feedback tells nerve to shut off/relax
• side fx: postural hypotension, dry mouth, fatigue

Question 9

alpha 1 blockers

Answer 9

• decrease arterial tone thru SNS (reduce afterload)
• in PERIPHERAL NS
• block propogation of AP, causing relaxation
• side fx: postural hypotension, dry mouth, fatigue
• receptor becomes tolerant v quickly –> only short term use

Question 10

DRI (direct renin inhibitor)

Answer 10

• decrease arterial tone thru hormonal regulation(reduce afterload)
• beta blocker that directly inhibits renin release
• drops GFR thru EA vasodilation
• raise K by reducing aldo

Question 11

ACEi

Answer 11

• decrease arterial tone thru hormonal regulation(reduce afterload)
• decrease production of AII, decrease entry of Ca into cell, decrease sm muscle contraction, relax arterial tone
• drops GFR thru EA vasodilation
• raise K by reducing aldo

-side fx: cough (ACE also metabolizes bradykinins)

Question 12

ARB (angiotensin receptor blocker)

Answer 12

• decrease arterial tone thru hormonal regulation(reduce afterload)
• block effect of AII, decrease entry of Ca into cell, decrease sm muscle contraction, relax arterial tone
• drops GFR thru EA vasodilation
• raise K by reducing aldo