Nephrology Meds and treatments

Question 1

Carbonic anhydrase inhibitor

Answer 1

Acetazolamide

Inhibits carbonic anhydrase -> inhibits HCO3 reabsorption
Proximal convoluted tubule

Uses:
Glaucoma - acute angle closure
idiopathic intracranial htn
Altitude sickness (resp alkalosis)
Metabolic alkalosis

S/E:
Metabolic acidosis - even with eyedrops
hypokalemia
Nephrolithiasis
Sulfa allergy

Question 2

Osmotic diuretics

Answer 2

Mannitol

Osmotic load that cannot be reabsorbed in the nephron -> prevents maximal concentration of urine

Uses:
Elevated ICP - short term
Acute angle closure glaucoma
Acute kidney injury

S/E:
Dilutional hyponatremia (early)
Hypernatremia (later - loss of free water)
Hyperosmolarity
Pulmonary edema

Question 3

Loop diuretics

Answer 3

Furosemide
Bumetanide
Torsemide
Ethacrynic acid (non sulfa drug)

Inhibit Na/Cl/K co-transporter in ascending loop of Henle

Uses:
CHF
Ascites
Pulmonary edema
Peripheral edema
Hypercalcemia - "loops lose calcium"

S/E:
Hypocalcemia
Hypokalemia
hyperuriciemia
ototoxicity
sulfa allergy

Question 4

Thiazide diuretics

Answer 4

HCTZ
chlorthialidone
Metolazone

Inhibit Na/Cl cotransporter in the distal convoluted tubule

Uses:
HTN
mild CHF
hypercalcuria when serum calcium normal
nephrogenic DI

S/E:
Hypokalemia
Hyponatremia
Hyperuricemia - avoid in gout
Hypercalcemia
Sulfa allergy

Question 5

K sparing diuretics - Aldosterone receptor antagonist

Answer 5

Sprionolactone
Eplerenone

Uses:
Hyperaldosteronism
CHF
Post MI
Portal hypertension
Acne, PCOS - spironolactone

S/E:
Hyperkalemia
Gynecomastia, menstrual irregularities - spironolactone

Question 6

K sparing diuretics - inhibit Na channels in collecting tubule

Answer 6

Amiloride
Triamterene

Uses:
HTN
Prevent hypokalemia from other diuretics
Lithium induced nephrogenic DI - amiloride

S/E:
Hyperkalemia