module 5 CV/ renal drugs pt1

Question 1

what is the role of natriuretic peptides (2)

Answer 1

reducing blood volume and promoting dilation of arterioles and veins
These protect heart during volume overload

Question 2

3 basic functions of diuretics

Answer 2

1. cleansing of extra cellular fluid and maintenance
2. maintenance of acid-base balance
3. excretion of metabolic wastes/foreign substances

Question 3

3 basic functions of kidneys

Answer 3

1. filtration
2. reabsorption
3. active secretion

Question 4

MOA diuretics

AE

Answer 4

block sodium and chloride reabsorption creating osmotic pressure w/in the nephron preventing passive reabsorption of water
AE: hypovolemia, acid-base imbalance, altered electrolytes

Question 5

What are diuretic classifications (5)

Answer 5

1. loop : Furosemide
2. Thiazide: HCTZ
3. Osmotic: mannitol
4. Potassium sparing (aldosterone antagonists & non-aldosterone antagonists)
5. Carbonic anhydrase inhibitors

Question 6

Furosemide (LOOP DIURETIC)
USE
AE

Answer 6

use: pulm edema, edematous states, htn
ae: hyponatremia, hypochloremia, dehydration, hypotension, hypokalemia, ototoxicity

Question 7

HCTZ AE

interactions

Answer 7

ae: hyponatremia, hypochloremia, hypokalemia, hyperglycemia, hyperuricemia, affect lipids/ca/mag
interactions: same as loops but not ototoxic

Question 8

Potassium sparing diuretics (3)

Answer 8

alodosterone antagonist: spironolactone
nonaldosterone antagonists: triamterene &
Amiloride

Question 9

Potassium sparing diuretics
MOA
uses

Answer 9

limited diuretic affects, mostly limit K excretion, not usually used alone but paired w k wasting diuretics
use: htn, edema, HF, vK, hyperaldosteronism, pms, pcos, acne

Question 10

Mannitol (OSMOTIC) IV
MOA
use

Answer 10

creates osmotic force that inhibits passive reabsorption, no sig effect on excretion of potassium and other electrolytes

Question 11

Where does each type of medication work in the RAAS?
renin inhibitors?
antagonist?

Answer 11

ACEi prevent ang1->ang2
ARB-block ang2 receptors
Renin inhibitor binds to renin and prevents conversion

Question 12

what is first dose hypotension

Answer 12

widespread vadodilation d/t vAng2 levels–likely in pts w severe htn, diuretics, vNa, volume depleted

Question 13

what is the cause of coughing with ACE

Answer 13

^bradykinin

Question 14

Ace inhibitors/ARBS

uses

Answer 14

use: htn, hf, MI, DM/non-diabetic nephropathy, prevention of MI/stroke/death

Question 15

why do arbs =less cough risk

Answer 15

they dont = bradykinin accumulation

Question 16

what can happen if ace/arbs given in pregnancy?

Answer 16

fetal injury

Question 17

what can happen if ace/arbs given in pt w renal artery stenosis

Answer 17

renal failure

Question 18

Aldosterone antagonists (3)
(blocks receptors)

Answer 18

Tekturna-renin inhibitor
Eplerenone
Spironolactone

Question 19

Tekturna-renin inhibitor use? se?

Answer 19

use: htn
se: cough/angiodema low, fetal injury, GI, ^k, death

Question 20

Eplerenone use? se?

Answer 20

Use: htn, hf
se:^K

Question 21

Spironolactone use? se?

Answer 21

use: htn, edema, HF, hyperaldosteronism, pms, pcos, acne
se: ^K, tumors, endocrine effects