Mechanisms/Drug Class

Question 1

What is the mechanism of action of renin inhibitors?

Answer 1

Inhibition of renin decreases conversion of angiotensinogen I, thereby reducing the substrate for ACE and decreasing subsequent arteriolar vasoconstriction, aldosterone synthesis, renal proximal tubule NaCl reabsorption, and ADH release

Question 2

aliskiren

Answer 2

Renin inhibitor

Question 3

What is the mechanism of action of ACE inhibitors?

Answer 3

Inhibition of ACE decreases conversion of angiotensin I to angiotensin II, thereby decreasing arteriolar vasoconstriction, aldosterone synthesis, renal proximal tubule NaCl reabsorption, and ADH release; ACE inhibitors also inhibit the degradation of bradykinin, and thereby increase vasodilation

Question 4

captopril

Answer 4

ACE inhibitor

Question 5

enalapril

Answer 5

ACE inhibitor

Question 6

ramipril

Answer 6

ACE inhibitor

Question 7

benazepril

Answer 7

ACE inhibitor

Question 8

fosinopril

Answer 8

ACE inhibitor

Question 9

moexipril

Answer 9

ACE inhibitor

Question 10

perindopril

Answer 10

ACE inhibitor

Question 11

quinapril

Answer 11

ACE inhibitor

Question 12

trandolapril

Answer 12

ACE inhibitor

Question 13

lisinopril

Answer 13

ACE inhibitor

Question 14

What is the mechanism of action of angiotensin II receptor antagonists?

Answer 14

They antagonize action of angiotensin II at AT1 receptor, may also increase vasorelaxant AT2 activity

Question 15

candesartan

Answer 15

angiotensin II receptor antagonist

Question 16

irbesartan

Answer 16

angiotensin II receptor antagonist

Question 17

losartan

Answer 17

angiotensin II receptor antagonist

Question 18

telmisartan

Answer 18

angiotensin II receptor antagonist

Question 19

valsartan

Answer 19

angiotensin II receptor antagonist

Question 20

What is the mechanism of action of B-type natriuretic peptide (BNP)?

Answer 20

BNP increases intracellular concentrations of cGMP by binding to the guanylyl cyclase receptor NPR-A of vascular smooth muscle and endothelial cells, resulting in smooth muscle relaxation

Question 21

nesiritide

Answer 21

B-type natriuretic peptide

Question 22

What is the mechanism of action of vasopressin receptor antagonists?

Answer 22

They have potent antagonist activity at V2 and weaker antagonist activity at V1, prevening vasopressin-stimulated water reabsorption via V2-coupled aquaporin channels in apical membrane of collecting duct cells

Question 23

conivaptan

Answer 23

vasopressin receptor 2 antagonist

Question 24

tolvaptan

Answer 24

vasopressin receptor 2 antagonist

Question 25

What is the mechanism of action of carbonic anhydrase inhibitors?

Answer 25

They inhibit sodium and bicarbonate reabsorption by noncompetitively and reversibly inhibiting proximal-tubule cytoplasmic carbonic anhydrase II and luminal carbonic anhydrase IV, leading to increased delivery of sodium bicarbonate to more distal segments of the nephron

Question 26

acetazolamide

Answer 26

carbonic anhydrase inhibitor

Question 27

What is the mechanism of action of osmotic diuretics?

Answer 27

They act as an osmole, filtered at the glomerulus but not subsequently reabsorbed in the nephron; exert an intraluminal osmotic force and limit reabsorption of water across water-permeable nephron segments

Question 28

mannitol

Answer 28

osmotic diuretic

Question 29

What is the mechanism of action of loop diuretics?

Answer 29

They inhibit sodium reabsorption by reversibly and competitively inhibiting sodium-potassium-chloride co-transporter NKCCS in apical (luminal) membrane of cells in thick ascending limp of loop of Henle; also reduce or abolish the lumen-positive transepithelial potential difference

Question 30

furosemide

Answer 30

loop diuretic

Question 31

bumetanide

Answer 31

loop diuretic

Question 32

torsemide

Answer 32

loop diuretic

Question 33

ethacrynic acid

Answer 33

loop diuretic

Question 34

What is the mechanism of action of thiazide diuretics?

Answer 34

They inhibit sodium chloride reabsorption by acting as competitive antagonists at NCC sodium-chloride co-transporter in apical (luminal) membrane of distal convoluted tubule cells; promote increased transcellular calcium reabsorption in distal convoluted tubule

Question 35

hydrochlorothiazide

Answer 35

thiazide diuretic

Question 36

bendroflumethiazide

Answer 36

thiazide diuretic

Question 37

hydroflumethiazide

Answer 37

thiazide diuretic

Question 38

polythiazide

Answer 38

thiazide diuretic

Question 39

chlorthalidone

Answer 39

thiazide diuretic

Question 40

metolazone

Answer 40

thiazide diuretic

Question 41

indapamide

Answer 41

thiazide diuretic

Question 42

What is the mechanism of action of collecting duct (potassium sparing) diuretics?

Answer 42

Spironolactone and eplerenone inhibit aldosterone action by binding to and preventing nuclear translocation of the mineralocorticoid receptor; amiloride and triamterene are competitive inhibitors of the principle cell membrane EnaC sodium channel

Question 43

spironolactone

Answer 43

collecting duct (potassium-sparing) diuretic

Question 44

eplerenone

Answer 44

collecting duct (potassium-sparing) diuretic

Question 45

amiloride

Answer 45

collecting duct (potassium-sparing) diuretic

Question 46

triamterene

Answer 46

collecting duct (potassium-sparing) diuretic