Moduule5Pharm Flashcards
Which is not a use for loop diuretics?
a) HTN
b) edema
c) pulmonary edema
d) diabetes insipidus
Answer: d) diabetes insipidus
Loop diuretics good in renal impaired patients and for those who have been unresponsive to other diuretics
Which diuretic produces the most fluid and electrolyte loss?
loop diuretics
Which is not a SE of loop diuretics:
a) hypoglycemia
b) hyponatremia
c) hyperkalemia
d) ototoxicity
e) one or more of the above
Answer: e) one or more of the above
SE: hyponatremia, hypochloremia, dehydration, hypokalemia, hypotension, OTOTOXIC, HYPERGLYCEMIA, hyperuricemia, lipid metabolism issues
What relationship can loop diuretics have with digoxin?
Digoxin toxicity due to loss of K (potassium)
If lithium and loop diuretics are administered in the same patient, what can happen?
a) lithium levels rise dangerously
b) lithium levels are not therapeutic (low)
c) loop diuretics can become toxic (high)
d) loop diuretics are not effective
Answer: a) lithium can rise dangerously due to decreased renal excretion
______ diuretic produces maximal diuresis compared to ______ diuretics. However ______ diuretics can be effective even when urine flow is decreased, whereas ______ diuretics are not.
choices: loop, thiazide, osmotic, potassium sparing
Loop diuretic produces maximal diuresis compared to thiazide diuretics. However thiazide diuretics can be effective even when urine flow is decreased, whereas loop diuretics are not.
Which is NOT a side effect of thiazide diuretics?
a) hyponatremia
b) hypokalemia
c) hyperglycemia
d) ototoxicity
Answer: d)ototoxicity
Loop diuretics however are ototoxic.
Which is not a loop diuretic?
a) torsemide
b) ethacrynic acid
c) amiloride
d) bumetide
Answer: c) amiloride
It is a potassium-sparing diuretic (nonaldosterone antagonist)
Where do thiazide diuretics act?
a) distal tubule
b) glomerulus
c) loop of henle
d) collecting tubule
Answer: a) distal tubule
They act in the early segment of the distal convoluted tubule
Which is not an indicated use for thiazide diuretics?
a) HTN
b) diabetes insipidus
c) edema
d) pulmonary edema
Answer: d) pulmonary edema
True or false, potassium-sparing diuretics produce a modest increase in urine production?
True. They work more-so when used in conjunction with another diuretic to decrease K+ loss.
Spironolactone is what type of diuretic?
a) loop
b) thiazide
c) potassium-sparing
d) osmotic
Answer: c) potassium sparing
Which of these are nonaldosterone antagonists?
a) spironolactone
b) triamterene
c) amiloride
d) mannitol
Answer: b & c
Note: spironolactone is an aldosterone antagonist
What is the MOA for spironolactone?
a) blocks action of aldosterone
b) directly inhibits the exchange mechanism for aldosterone
c) creates an osmotic gradient
d) causes vasoconstriction which stimulates aldosterone
Answer: a) blocks action of aldosterone
This will increase the “peeing” out of sodium and the retention of K+ and H+
What is the MOA for triamterene?
a) blocks action of aldosterone
b) directly inhibits the exchange mechanism for aldosterone
c) creates an osmotic gradient
d) causes vasoconstriction which stimulates aldosterone
Answer: b) directly inhibits the exchange mechanism itself
DOES NOT block aldosterone it just blocks the pump
Which is not a SE of spironolactone?
a) hyperkalemia
b) gynecomastia
c) impotence
d) hirsutism
e) hyperglycemia
Answer: e) hyperglycemia
Other SE: deeper voice, menstrual irregularities
What medications should be carefully considered when using spironolactone?
a) ACE
b) ARBs
c) CCB
d) K+ supps
e) one or more of the above
Answer: e) one or more of the above
a, b, and d
Avoid anything that is prone to causing hyperkalemia as spironolactone is a potassium-sparing diuretic
Which is a use for triamterene?
a) diabetes insipidus
b) HTN
c) edema
d) acne
Answer: b&c
Triamterene is a potassium sparing diuretic.
Which is a use for spironolactone?
a) hyperaldosteronism
b) acne
c) premenstrual syndrome
d) diabetes insipidus
e) one or more of the above
Answer: e) one or more of the above
Uses include: a, b, c, and hypokalemia, HTN, edema, polycystic ovary syndrome
Which is not an adverse effect of triamterene?
a) hyperkalemia
b) n/v
c) blood dyscrasia
d) impotence
Answer: d) impotence
Other SE: leg cramps
What is the MOA of mannitol?
a) blocks action of aldosterone
b) directly inhibits the exchange mechanism for aldosterone
c) creates an osmotic gradient
d) causes vasoconstriction which stimulates aldosterone
Answer: c) creates an osmotic gradient
Creates osmotic force within the lumen of nephron
What is an indicated use for mannitol?
a) HTN
b) prophylaxis of renal failure
c) elevated ICP
d) edema
e) one or more of the above
Answer: e) one or more of the above
Indicated uses are: prophylaxis for renal failure, elevated IOP, elevated ICP
What is a side effect of mannitol?
a) hyperkalemia
b) blood dyscrasia
c) impotence
d) seizures
Answer: d) seizures
Which ace inhibitors can be combined with a CCB?
a) peridonpril
b) enalapril
c) trandolapril
d) fosinopril
e) one or more of the above
Answer: a & c
Other ACE inhibitor which can be given with a CCB is benazepril
Which ACE inhibitor is a prodrug and does not need to be converted to active form?
a) peridonpril
b) enalapril
c) moxepril
d) lisinopril
Answer: d) lisinopril
Which ACE inhibitor is not given orally?
a) peridonpril
b) enalapril
c) moxepril
d) lisinopril
Answer: b) enalapril
Which ace inhibitors should not be given with food?
a) catopril
b) enalapril
c) moxepril
d) lisinopril
e) one or more of the above
Answer: e) one or more of the above
Catopril & Moxepril cannot be given with food.
What does an ACE inhibitor do?
Prevent conversion of angiotensin 1 to angiotensin 2.
Only ACE inhibitor that doesn’t need renal dosing:
a) catopril
b) enalapril
c) moxepril
d) fosinopril
Answer: d) fosinopril
Which is NOT a use for ACE inhibitors?
a) HTN
b) MI
c) HF
d) Stroke
Answer: d) stroke
Other uses are diabetic/nondiabetic neuropathy and diabetic retinopathy
MOA of ACE inhibitors (detailed):
Prevents angiotensin I–>angiotensin II. Causes blood vessels to dilate (mainly arterioles, not veins), reduces blood volume, prevent pathologic changes in heart. It also increases levels of bradykinin and is excreted by kidney.
True or false, ACE inhibitors can reduce mortality after an MI and should be given ASAP.
True. They should be continued 6 weeks after MI.
Which is not an adverse effect of ACE inhibitors:
a) first-dose hypotension
b) hypokalemia
c) angioedema
d) neutropenia
e) renal failure in those with bilateral renal artery stenosis
Answer: b) hypokalemia
ACE inhibitors inhibit angiotensin I from converting to angiotensin II which causes potassium to be retained.
Other SE: fetal injury, cough,
True or false, ACE inhibitors can cause lithium to accumulate to toxic levels.
True.
Which medications can cause lithium to accumulate to toxic levels?
a) ACE inhibitors
b) loop diuretics
c) ARBs
d) thiazide diuretics
e) one or more of the above
Answer: e) one or more of the above
ACE inhibitors and loop diuretics can cause lithium to accumulate to toxic levels.
What is the MOA of ARBs?
a) blocks action of aldosterone
b) directly inhibits the exchange mechanism for aldosterone
c) creates an osmotic gradient
d) blocks the action of angiotensin II
Answer: d) blocks the action of angiotensin II
Note: it DOES NOT block the production of angiotensin II (ACE inhibitors have that function)
