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PH 113 - Pharmacology 1 > MIDTERM 04 - Diuretics > Flashcards

MIDTERM 04 - Diuretics Flashcards

1
Q

Basic unit of the kidneys

A

Nephron

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2
Q

3 steps of urine formation (GTT)

A

Glomerular filtration, Tubular reabsorption, Tubular secretion

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3
Q

Forerunners of diuretics; blocks carbonic anhydrase; its segment is the PCT (Types of diuretics)

A

Carbonic anhydrase inhibitors

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4
Q

2 most common carbonic anhydrase inhibitors; used for the reduction of aqueous humor production in glaucoma (DB)

A

Dorzolamide, Brinzolamide

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5
Q

Contraindication for carbonic anhydrase inhibitors

A

Liver cirrhosis

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6
Q

Used for reduction of intraocular pressure (IOP) and intracranial pressure (ICP); its segment is the PCT and descending LoH (Types of diuretics)

A

Osmotic diuretics

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7
Q

Prototype drug of osmotic diuretics

A

Mannitol (IV)

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8
Q

Mannitol (IV) and urea are examples of __________

A

Osmotic diuretics

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9
Q

High-ceiling, most efficacious diuretics; blocks the luminal NKCC2; its segment is the thick ascending limb of LoH (Types of diuretics)

A

Loop diuretics

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10
Q

Its most important use is for acute pulmonary edema and peripheral edema (Types of diuretics)

A

Loop diuretics

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11
Q

Blocks NCC; its segment is the DCT (Types of diuretics)

A

Thiazide diuretics

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12
Q

Prototype drug of thiazide diuretics

A

Hydrochlorothiazide

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13
Q

Parent compound of thiazide diuretics

A

Chlorothiazide

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14
Q

Hydrochlorothiazide and chlorothiazide are examples of __________

A

Thiazide diuretics

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15
Q

Chlorthalidone, indapamide, and metolazone are examples of __________

A

Thiazide-like diuretics

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16
Q

Thiazide diuretics are ineffective at GFT <30 to 40 mL/mine, except ___________ and __________ (MI)

A

Metolazone, Indapamide

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17
Q

A thiazide-like diuretic that is more potent; acts both on PCT and DCT (Types of diuretics)

A

Metolazone

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18
Q

Its segment is the collecting tubules and ducts; used for primary and secondary hyperaldosteronism and Liddle syndrome (Types of diuretics)

A

K+ sparing diuretics

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19
Q

2 K+ sparing diuretics that are steroidal MRAs (SE)

A

Spironolactone, Eplerenone

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20
Q

3 K+ sparing diuretics that are nonsteroidal MRAs (FEA)

A

Finerenone, Esaxerenone, Apararenone

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21
Q

2 K+ sparing diuretics that block Na+ entry in the epithelial Na+ channels (ENAC) (AT)

A

Amiloride, Triamterene

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22
Q

Spironolactone, eplerenone, triamterene, and amiloride are examples of __________

A

K+ sparing diuretics

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23
Q

Inhibits SGLT-2; its segment is the PCT (Types of diuretics)

A

SGLT-2 inhibitors

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24
Q

Dapagliflozin, canagliflozin, empagliflozin, ertugliflozin, and ipragliflozin are examples of __________

A

SGLT-2 inhibitors

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25
Q

SGLT-2 inhibitors are used for __________; they reduce CV death and hospitalization regardless of presence or absence of DM

A

HFrEF

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26
Q

Considered as a 3rd-line therapy for DM (Types of diuretics)

A

SGLT-2 inhibitors

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27
Q

SGLT-2 inhibitors are __________; they reduce CV mortality, nonfatal stroke, and nonfatal MI

A

Cardioprotective

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28
Q

SGLT-2 inhibitors are __________; they protect against declining renal function, ESRD, death due to kidney disease, and AKI

A

Renoprotective

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29
Q

Cardiac atria (Natriuretic peptide)

A

Atrial NP

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30
Q

Cardiac ventricles (Natriuretic peptide)

A

Brain NP

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31
Q

CNS, Kidneys (Natriuretic peptide)

A

C-type NP

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32
Q

Kidneys (Natriuretic peptide)

A

Urodilatin

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33
Q

Cardiac atria (Recombinant analog)

A

Carperitide

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34
Q

Cardiac ventricles (Recombinant analog)

A

Nesiritide

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35
Q

Kidneys (Recombinant analog)

A

Ularitide

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36
Q

Binds to NP receptors (NPRs); its segment is the intramedullary collecting duct (Types of diuretics)

A

Natriuretic peptides

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37
Q

NPR A and B are __________ receptors

A

Guanylyl cyclase

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38
Q

Used for acute decompensated HF w/ dyspnea at rest or minimal activity (Examples of natriuretic peptides)

A

Nesiritide

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39
Q

Is studied in acute HF (Examples of natriuretic peptides)

A

Ularitide

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40
Q

A 1:1 mixture of 8-bromotheophylline and 2-amino-2-methyl-1-propanol (Examples of adenosine antagonists)

41
Q

Are nonselective adenosine receptor antagonists; examples include caffeine, theophylline, and theobromine (Examples of adenosine antagonists)

A

Methylxanthines

42
Q

4 adenosine receptors

A

A1, A2a, A2b, A3

43
Q

Adenosine receptor found in pre-glomerular afferent arteriole (decreases RBF and GFR) and PCT (stimulates NHE3 and Na+ reabsorpstion)

44
Q

Blocks A1 receptors causing diuresis w/o K+ wasting; its segment is PCT; used as OTC for premenstrual syndrome (Types of diuretics)

A

Adenosine antagonists

45
Q

Used in refractory patients to loop diuretics alone (Diuretic combinations)

A

Loop + Thiazides

46
Q

Used in preventing hypokalemia; avoided in renal insufficiency and in ACEI recipients (Diuretic combinations)

A

K+ sparing + CA inhibitors/Loop/Thiazides

47
Q

Used in renal failure w/ very low GFR (Diuretic combinations)

A

Furosemide + Metolazone

48
Q

Heart failure (Edematous or non-edematous state)

49
Q

Renal failure (Edematous or non-edematous state)

50
Q

Liver cirrhosis (Edematous or non-edematous state)

51
Q

Idiopathic edema (Edematous or non-edematous state)

52
Q

Hypertension (Edematous or non-edematous state)

A

Non-edematous

53
Q

Nephrolithiasis (Edematous or non-edematous state)

A

Non-edematous

54
Q

Hypercalcemia (Edematous or non-edematous state)

A

Non-edematous

55
Q

Diabetes insipidus (Edematous or non-edematous state)

A

Non-edematous

56
Q

Renoprotection and cardioprotection (Edematous or non-edematous state)

A

Non-edematous

57
Q

Used for severe edema (Heart failure - diuretics used)

A

Loop + Thiazide

58
Q

Used to correct alkalosis (Heart failure - diuretics used)

A

Loop + CA inhibitor

59
Q

Used to correct alkalosis and hypokalemia (Heart failure - diuretics used)

A

Loop + K+ sparing

60
Q

Enhances K+ excretion and used for hyperkalemia (Renal failure - diuretics used)

A

Thiazide/Loop diuretic

61
Q

Used to control the volume-dependent component of hypertension of nephrotic syndrome (Renal failure - diuretics used)

A

Loop diuretic

62
Q

Used for treatment of volume overload in dialysis or predialysis patients (Renal failure - diuretics used)

A

High-dose furosemide/Furosemide + Metolazone

63
Q

Exacerbates acidosis (Renal failure - diuretics used)

A

Acetazolamide

64
Q

Causes hyperkalemia (Renal failure - diuretics used)

A

K+ sparing diuretics

65
Q

Ineffective at GFR <30 mL/min; can be used to reduce the dose of loop diuretics (Renal failure - diuretics used)

A

Thiazide diuretics

66
Q

Ineffective because of decreased secretion of the drug into the tubular fluid (Hepatic cirrhosis - diuretics used)

A

Loop diuretics

67
Q

Is effective; has potential for causing serious hyperkalemia (Hepatic cirrhosis - diuretics used)

68
Q

Relative contraindication for hepatic cirrhosis; is effective but increases liver function tests

69
Q

2 ADRs from excessive diuretic use for hepatic cirrhosis (HH)

A

Hepatorenal syndrome, Hepatic encephalopathy

70
Q

Edema characterized by fluctuating salt retention and edema

A

Idiopathic edema

71
Q

Idiopathic edema is sometimes treated with ____________

A

Spironolactone

72
Q

Used as the 1st-line diuretic for essential hypertension; enhances the efficacy of ACE inhibitors (Hypertension - diuretics used)

A

Thiazide diuretics

73
Q

More effective than HCTZ due to long half life but has more adverse effects (Hypertension - diuretics used)

A

Chlorthalidone

74
Q

Reserved for patients with mild renal insufficiency or heart failure (Hypertension - diuretics used)

A

Loop diuretics

75
Q

Used to reduce K+ wasting (Hypertension - diuretics used)

A

K+ sparing diuretics

76
Q

May be the most effective single agent in the therapy of drug-resistant hypertension (Hypertension - diuretics used)

A

Spironolactone

77
Q

Enhances Ca2+ reabsorption in the DCT and reduces the urinary Ca2+ concentration (Nephrolithiasis - diuretics used)

A

Thiazide diuretics

78
Q

Reduces Ca2+ reabsorption significantly and effectively promoting Ca2+ diuresis (Hypercalcemia - diuretics used)

A

Loop diuretics

79
Q

__________ is treated with ADH analogs (Types of diabetes insipidus)

A

Neurogenic/Central DI

80
Q

Can reduce polyuria and polydipsia; blocks Li-induced NDI (Diabetes insipidus - diuretics used)

A

Thiazide diuretics

81
Q

Blocks Li induced polyuria (Diabetes insipidus - diuretics used) (AT)

A

Amiloride, Triamterene

82
Q

Are efficacious in reducing polyuria w/ fever adverse effects (Diabetes insipidus - diuretics used)

A

Acetazolamide

83
Q

Cardioprotective in patients w/ heart disease (Renoprotection and cardioprotection - diuretics used)

84
Q

Carbonic anhydrase inhibitors (MOA)

A

Blocks carbonic anhydrase

85
Q

Carbonic anhydrase inhibitors (Segment)

86
Q

Osmotic diuretics (Segment)

A

PCT and descending LoH

87
Q

Loop diuretics (MOA)

A

Blocks NKCC2

88
Q

Loop diuretics (Segment)

A

Thick ascending limb of LoH

89
Q

Thiazide diuretics (MOA)

A

Blocks NCC

90
Q

Thiazide diuretics (Segment)

91
Q

K+ sparing diuretics (MOA)

A

Blocks ENaC

92
Q

K+ sparing diuretics (Segment)

A

Collecting tubules and ducts

93
Q

SGLT-2 inhibitors (MOA)

A

Inhibits SGLT-2

94
Q

SGLT-2 inhibitors (Segment)

95
Q

Natriuretic peptides (MOA)

A

Binds to NP receptors (NPRs)

96
Q

Natriuretic peptides (Segment)

A

Intramedullary collecting duct

97
Q

Adenosine antagonists (MOA)

A

Blocks A1 receptors

98
Q

Adenosine antagonists (Segment)

PH 113 - Pharmacology 1 (17 decks)

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