Medication Study Guide Exam 1

Question 1

Osmotic Diuretics Drug

Answer 1

Mannitol

Question 2

Osmotic Diuretics MoA

Answer 2

Increase osmolarity of the glomerular filtrate

Question 3

Osmotic Diuretics Site of Action

Answer 3

Proximal tubule, descending limb, collecting tubule

Question 4

Osmotic Diuretics Effects

Answer 4

Increase water excretion with a smaller increase in Na excretion

Question 5

Osmotic Diuretics Indications

Answer 5

Acute renal failure
Reduce intraocular/intracranial pressure

Question 6

Osmotic Diuretics Side Effects

Answer 6

Expand extracellular fluid volume (risk of HF)
Hyponatremia
Headache
Nausea
Vomiting

Question 7

Osmotic Diuretics Contraindications

Answer 7

Anuria, severe hypovolemia, heart failure

Question 8

CA inhibitor Examples

Answer 8

Acetazolamide
Dorzolamide

Question 9

CA inhibitor MoA

Answer 9

Inhibition of carbonic anhydrase

Question 10

CA inhibitor Site of Action

Answer 10

Proximal convoluted tubule

Question 11

CA inhibitor Effects

Answer 11

Increase excretion of bicarbonate, Na, K, and H2O

Question 12

CA inhibitor Indications

Answer 12

Glaucoma
Metabolic alkalosis (keeps bicarb out of circulation)
Infantile epilepsy
Altitude sickness

Question 13

CA inhibitor Side Effects

Answer 13

Metabolic acidosis (keeps bicarb out of circulation)
Renal stones
Hypokalemia

Question 14

CA inhibitor Contraindications

Answer 14

Hepatic cirrhosis
Increase reabsorption of basic drugs

Question 15

What effects does AngII have on the AT1 receptor?

Answer 15

Vasoconstriction
Hypertrophic effects
Oxidative stress
Inflammation
Aldosterone secretion

Question 16

Angtiotensinogen pathway to AT1 receptor

Answer 16

Angiotensinogen + Renin -> AngI
AngI + ACE -> AngII -> AT1

Question 17

Renin secretion stimulated by

Answer 17

Low renal perfusion
Beta-1 activation (Beta blockers affect this to decrease renin secretion)
Sodium loss (esp. thiazide/loop diuretics)

Question 18

Renin is inhibited by

Answer 18

AngII (negative feedback loop)
Atrial natriuretic peptide (ANP)

Question 19

Bradykinin

Answer 19

Part of the kallikrein-kinin system
Potent vasodilator, releases NO and prostacyclin
ACE inhibitors allow bradykinin to not be degraded

Question 20

High levels of AngII can cause

Answer 20

Hypertrophy
Inflammation
Fibrosis
Apoptosis

Question 21

ACE Inhib Indications

Answer 21

Heart:
HTN
HF
Post MI

Kidney:
Diabetic nephropathy
Chornic renal insufficiency

Question 22

ACE Inhib Side Effects

Answer 22

Hypotension
Hyperkalemia
Dry cough due to inflammatory molecules like bradykinin (take aspirin or switch to ARB)
(Rare) Angioedema due to bradykinin
Captopril can affect taste, skin rxn, drug fever

Question 23

ACE Inhib Contraindications

Answer 23

PREGNANCY (teratogenic)
Angioedema due to ACE Inhibs
Bilateral renal artery stenosis

Question 24

ACE Inhib Interactions

Answer 24

Hypotensive with diuretics/sympatholytics
Hyperkalemia with K-sparing diuretics or K supplements
NSAIDs may impair ACE inhib hypotensive effects (NSAIDs block bradykinin vasodilation)
Reduce Li clearance, risk of lithium toxicity

Question 25

Captopril

Answer 25

Short acting, non-prodrug

Question 26

Lisinopril

Answer 26

Long acting, non-prodrug

Question 27

Fosinopril

Answer 27

Long acting, prodrug, NO RENAL ADJUSTMENT (metabolized 50% in liver)

Question 28

ACE Inhibs that are not captopril, lisinopril, or fosinopril

Answer 28

Prodrug and long acting