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RENAL II Exam 3 > Intro to Antihypertensive Agents II > Flashcards

Intro to Antihypertensive Agents II Flashcards

1
Q

acetazolamide

A

carbonic anhydrase inhibitor

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2
Q

brinzolamide

A

carbonic anhydrase inhibitor

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3
Q

dorzolamide

A

carbonic anhydrase inhibitor

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4
Q

methazolamide

A

carbonic anhydrase inhibitor

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5
Q

furosemide

A

loop diuretic

lasix

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6
Q

ethacrynic acid

A

loop diuretic

-will not cause sulfa allergy**

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7
Q

bumetanidine

A

loop diuretic

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8
Q

torsemide

A

loop diuretic

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9
Q

HCTZ

A

thiazide diuretic

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10
Q

chlorothiazide

A

thiazide diuretic

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11
Q

hydroflumethiazide

A

thiazide diuretic

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12
Q

indapamide

A

thiazide diuretic

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13
Q

methylclothiazide

A

thiazide diuretic

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14
Q

metolazone

A

thiazide diuretic

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15
Q

polythiazide

A

thiazide diuretic

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16
Q

trichlormethiazide

A

thiazide diuretic

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17
Q

eplerenone

A

K sparing

-aldosterone antagonist

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18
Q

spironolactone

A

K sparing

-aldosterone antagonist

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19
Q

amiloride

A

K sparing

-ENaC inhibitor

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20
Q

triamterene

A

K sparing

-ENaC inhibitor

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21
Q

mannitol

A

aquaretic

-osmotic diuretic

22
Q

isosorbide

A

aquaretic

-osmotic diuretic

23
Q

conivaptan

A

aquaretic

-ADH antagonist

24
Q

tolvaptan

A

aquaretic

-ADH antagonist

25
Q

carbonic anhydrase inhibitors

A
  • proximal convoluted tubule
  • membrane bound and cytoplasmic forms of enzyme

-result in decreased H formation in cell
> decreased Na/H antiport
> increased Na and HCO3 in lumen
> increased diuresis

urine pH increase and body pH decrease

hypokalemia, but metabolic acidosis

26
Q

indications for CAIs

A

rarely used - develop metabolic acidosis

-glaucoma, acute mountain sickness, metabolic alkalosis

27
Q

adverse effects of CAIs

A
  • acidosis
  • hypokalemia
  • renal stones
  • paresthesias
  • sulfonanide hypersensitivity
28
Q

loop diuretics

A

-inhibit lumen Na/K/2Cl cotransporter in thick ascending limb

-increased lumen Na, K and Cl
>decreased back diffuse of K and positive potential in lumen
>decreased reabsorption of Ca and Mg
>diuresis

among most efficacious diuretics**

good for edematous states

29
Q

loop diuretic activity

A

tied to secretion rate
-half life correlates to kidney function

  • 0.5-2 hours (healthy)
  • 9 hours (ESRD)
30
Q

adverse effects of loop diuretics

A

hypokalemia, alkalosis, hypocalcemia, hypomagnesemia, hyperuricemia, ototoxicity, sulfonamide hypersensitivity (not all)

31
Q

thiazide diuretics

A

inhibits Na/Cl cotransport and block Na/Cl reabsorption in distal convoluted tubule

-increased lumen Na and Cl in DCT
> diuresis

-increased reabsorption of Ca in PCT
>due to volume contraction

**indicated for kidney stones (like loop diuretics)

32
Q

uses for thiazide diuretics

A

HTN, mild heart failure, nephrolithiasis, nephrogenic diabetes insipidus

33
Q

side effects of hyperglycemia and hyperlipidemia

A

thiazide diuretics

caution in diabetic patients

34
Q

adverse effects of thiazide diuretics

A

hypokalemia, alkalosis, hypercalcemia, hyperuricemia, hyperglycemia, hyperlipidemia, sulfonamide hypersensitivity

*caution with diabetics

35
Q

mechanisms of K sparing diuretics

A
  • mineralocorticoid receptor antagonists
  • ENaC inhibitors

both decrease ENaC at luminal membrane
>no Na reabsorption at collecting tubule
>no loss of potassium

**no hypokalemia

**add this to stop hypokalemia with other drugs

36
Q

mineralocorticoid receptor antagonists

A

inhibit aldosterone
>decreased ENaC in principal cells of collecting duct
>diuresis

**don’t require access to tubular lumen

37
Q

clinical for K sparing diuretics (MR antagonists)

A

hyperaldosteronism, antiandrogenic use, heart failure

38
Q

clinical for K sparing diuretics (ENaC (-))

A

adjunct for K-wasting diuretics, lithium induced nephrogenic diabetes insipidus

39
Q

adverse effects for K sparing diuretics (MR antagonists)

A

hyperkalemia, acidosis, antiandrogenic effects

40
Q

adverse effects of K sparing diuretics (ENaC inhibitors)

A

hyperkalemia and acidosis

41
Q

mineralocorticoid receptor

A

nuclear hormone receptor
-natural agonist is mineralocorticoids influence salt and water balance

ex agonists/ aldosterone, deoxycorticosterone, cortisol

aka aldosterone receptor

42
Q

CAIs and pH

A

decreased body pH

43
Q

loop diuretics and pH

A

increased body pH

44
Q

loop agent plus thiazides and pH

A

increased body pH

45
Q

K sparing diuretics and pH

A

decrease body pH

46
Q

all diuretics

A

increased NaCl in urine

47
Q

diuretics and HCO3

A

CAIs have largest urinary HCO3

-therefore acidosis occurs

48
Q

all diuretics except K sparing

A

increased K in urine

-hypokalemia

49
Q

CAIs and K sparing diuretics

A

decreased body pH

50
Q

loop agents, thiazides, loop agents plus thiazides

A

increased body pH

RENAL II Exam 3 (17 decks)

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