Lecture 1- Diuretics/HTN

Question 1

where do carbonic anhydrase inhibitors work?

Answer 1

proximal tubules (where 70% of Na is reabsorbed)

Question 2

CA inhibitors block transport of

Answer 2

Na and bicarb

Question 3

Acetazolamide and methazolamide are …

Answer 3

Carbonic Anhydrase inhibitors (diuretic)

Question 4

an … diuretic is a type of diuretic that inhibitrs reabsorp. of water and sodium. they are pharmacologically inert substances that are given IV. They increase the osmolarity of blood and renal filtrate.

Answer 4

osmotic

Question 5

Mannitol and isosorbide are … diuretics

Answer 5

osmotic

Question 6

Loop diuretics work in the …

Answer 6

thick ascending loop (where 25% of Na is reabsorbed)

Question 7

How do loop diuretics work?

Answer 7

block Na/2Cl/K symporter

Question 8

loop diuretics can lead to imbalances in …. and … and is also linked to kicking … out

Answer 8

Mg and Ca

K

Question 9

…. diuretics are used in medicine to treat HTN and edema often due to CHF or renal insufficiency

Answer 9

loop

Question 10

…. diuretics are more effective in patients with normal kidney function

Answer 10

thiazide

Question 11

which diuretics are best for patients with impaired kidney fxn?

Answer 11

loop

Question 12

what allergy do you have to worry about with loop diuretics?

Answer 12

sulfa

Question 13

furosemide, torasemide, bumetanide are … derivatives and they are all …. diuretics

Answer 13

sulfonamide

loop

Question 14

thiazide diuretics work where?

Answer 14

distal tubule (5-10% Na reabsorbed here)

Question 15

how do thiazide diuretics work?

Answer 15

secreted in the proximal tubule but works in the DCT

inhibits Na/Cl symporter from lumen

Question 16

chlorthalidone, indapamide and metolazone are …. diuretics

Answer 16

thiazide

Question 17

4 classes of drugs to treat HTN

Answer 17

diuretics

sympathoplegic agents

direct vasodilators

block angiotensin 2 production or activity

Question 18

3 ways sympathoplegic agents work to treat HTN

Answer 18

act on CNS

reduce release of epi from symp nerve endings

block selective adrenoreceptors

Question 19

methyl dopa, guanfacine, guanabenze, clonidine are all…

Answer 19

sympathoplegic agents to treat HTN by activating alpha2 receptors in the CNS

Question 20

Reserpine and Guanethidine are ….

Answer 20

sympathoplegic agents to reduce HTN by reducing release of epi from sympathetic nerve endings

Question 21

-olol’s treat HTN by blocking… which diminishes … and …

Answer 21

beta receptors

CO

renin production

Question 22

prazosin, terazpsin, and doxazosin treat …. by blocking…. resulting in blocking ….

Answer 22

HTN

alpha1 receptors

vasoconstriction

Question 23

4 ways direct vasodilators work

Answer 23

1. nitric oxide pro-drugs that promote NO release from the endothelium
2. reduce Ca influx into vascular smooth muscle
3. hyperpolarization of vascular smooth muscle by opening K channels
4. activation of dopamine receptors

Question 24

3 nitric oxide pro-drugs

Answer 24

1. sodium nitroprusside
2. hydralazine
3. nitrates, nitroglycerin, isosorbide dinitrate, amyl nitrate

Question 25

verapamil, diltiazem, and nifedipine MOA?

Answer 25

direct vasodilators- reduce Ca influx into vascular smooth muscle

Question 26

minoxidil, diazoxide MOA

Answer 26

treat HTN by causing hyperpolarization of vascular smooth muscle by opening K channels

Question 27

fenoldopam MOA?

Answer 27

treat HTN by activating dopamine receptors

Question 28

losartan, valsartan MOA

Answer 28

treat HTN by competitive antagonism of angiotensin receptors

Question 29

aliskiren is a …. inhibitor

Answer 29

renin

Question 30

spironolactone, amilorida and eplerenone MOA

Answer 30

treat HTN through aldosterone receptor antagonism