Pharm 21: Lasik make pee

Question 1

ADH MOA

Answer 1

Constricts vasculature and promotes water reabsorption via G-protein receptors

V1: vascular smooth muscle contriction
V2: collecting duct of principal cells

Question 2

ADH V2 activity (MOA)

Answer 2

Gs g-protein

CAMP increases ->protein kinase A (PKA) increases

PKA increases aquaporin 2 activity

Question 3

Aliskiren MOA and use

Answer 3

Renin inhibitor. Binds to active site inhibiting the binding of renin

Used for hypertension with renal insufficiency

Can be used w/ thiazides

Question 4

Kinin levels w/ ACE inhibitors

Answer 4

Are increased

Question 5

ACE inhibitors metabolism patterns

Answer 5

1) Captopril. Active, biotransformed to active metabolite

2) Enalapril/ Ramipril: prodrug. if at suffix then active

3) Lisinopril: active form, excreted unchanged by kidney

Question 6

ACE inhibitor cough angioedema because

Answer 6

Potentiation of bradykinin

Question 7

ACE inhibitors and potassium

Answer 7

Reduced aldosterone synthesis causes hyperK

Question 8

Losartan and Valsartan MOA

Answer 8

AT1 receptor antagonist. —> Angotensin II inhibition

Question 9

AT1 receptor antagonist vs ACE inhibittor

Answer 9

AT1 more complete angiotensin II inhibition, but no vasodilation

Question 10

Nesiritide MOA and use

Answer 10

Recombinant BNP

Short term decompensated HF

Question 11

Demclocycline MOA and use

Answer 11

MOA unk

Use for SIADH

tretracycline *

Question 12

Conivaptan/tolvaptan MOA and use

Answer 12

V1/V2 (vasopressin) receptor antagonists

Tolvaptan is oral

use in SIADH and nephrogenic diabetes insipidus

Question 13

Acetalozimide MOA

Answer 13

inhibit sodium reabsorption by noncompetitively and reversibly inhibiting carbonic anhydrase in proximal tubule cells

Question 14

Acetazolimide compensation

Answer 14

NaCl and NaHCO3 reabsorption increases after some days

Question 15

Acetozolamide uses

Answer 15

Mountain sickness, times when urine alkanization is needed

Question 16

Mannitol MOA and use

Answer 16

Osmotic diuretic

Increased ICP

Question 17

Loop diuretic consequences (acid/base)

Answer 17

Volume contraction alkalosis

Question 18

Loop diuretics

Answer 18

Furosemide
Bumentanide
Torsemide
Ethacrynic acid (non sulfa)

Question 19

Loop diuretics MOA

Answer 19

These agents reversibly and competitively inhibit the Na+-K+-2Cl− co-transporter NKCC2 in the apical (luminal) membrane of thick ascending loop epithelial cells

Question 20

Lasix lab values

Answer 20

Hypocalcemia
Hypomagnesia
Hypokalemia

Question 21

Thiazides MOA and use

Answer 21

competitive antagonists of the NCC Na+-Cl− co-transporter in the luminal membrane of distal convoluted tubule cells

Decrease urinary calcium

First line for hypertension (decreased mortality)

used for osteoporosis or stone prevention

Question 22

Chlorthalidone

Answer 22

Used for night BP elevations

Question 23

Central diabetes insipidus treatment

Answer 23

Desmopressin (replace ADH)

Question 24

Spironolactone and eplerenone MOA

Answer 24

inhibit aldosterone action by binding to and preventing nuclear translocation of the mineralocorticoid receptor

Question 25

Amiloride and trimterene MOA and use

Answer 25

competitive inhibitors of the ENaC Na+ channel in the apical membrane of collecting duct principal cells

Hypertension (Liddle’s)

Question 26

Potassium sparing diuretics AEs

Answer 26

HyperK

Metabolic acidosis

Question 27

Amiloride consideration with lithium

Answer 27

Helps with kidney issues

Question 28

Liver failure ascites diuretic?

Answer 28

Potassium sparing