pharm

Question 1

Acetazolamide

Answer 1

carbonic anhydrase inhibitor (inhibits in PCT)

Question 2

furosemide

Answer 2

Loop diuretic; inhibits Na-K-2Cl transporter in Loop

Question 3

hydroclorathiazide

Answer 3

Thiazide diuretic: inhibits Na-Cl transport in DCT

Question 4

spironolactone

Answer 4

K sparing; competitively binds aldosterone receptor in CCT

Question 5

triamterene

Answer 5

K sparing; blocks ENaC channels in CCT

Question 6

amiloride

Answer 6

K sparing; blocks ENaC channels in CCT

Question 7

mannitol

Answer 7

osmotic diuretic

-not reabsorbed and causes water to be excreted along with it

Question 8

conivaptan

Answer 8

ADH antagonist

blocks the action of ADH on medullary collecting tubule

Question 9

acetazolamide AE

Answer 9

• metabolic acidosis (dec reabsorption bicarb)
• phosphaturia and hypercalciuria→stones
• K wasting (enhanced K+ secretion)
• drowsiness/fatigue (inhibit CA in CNS)
• paresthesias
• contraindicated in liver disease! (inc. ammonia in circulation)

Question 10

furosemide AE

Answer 10

Inc .urinary excretion K and H

• hypokalemic metabolic alkalosis (inc. distal Na delivery)
• hypochloremic alkalosis
• hypomagnesemia
• hyperuricemia (can ppt gout)
• dose related hearing loss
• sulfa allergy
• dehydration (Excess ECF vol depletion)
• inc LDL and dec HDL

Question 11

HCTZ AE

Answer 11

• hypokalemic metabolic alkalosis
• depletion Na, K, Cl, Mg
• retention uric acid (ppt gout)
• hyperglycemia
• hyperlipidemia
• photosensitivity (rare)

Question 12

spironolactone AE

Answer 12

• hyperkalemia
• hyperchloremic metabolic acidosis
• gynecomastia, hirsutism, impotence, BPH, menstrual irregs

Question 13

triamterine/amiloride AE

Answer 13

• hyperkalemia

- hyperchloremic metabolic acidosis

Question 14

mannitol AE

Answer 14

• extracts water from cells, prior to diuresis acute inc. in ECF vol and hyponatremia
• nausea, vomiting, headache
• require adequate water replacement→severe dehydration, hypernatremia

Question 15

vaptan AE

Answer 15

can cause severe hypernatremia and nephrogenic DI

Question 16

acetazolamide Uses

Answer 16

• alkalinize urine
• treat alkalosis: induces hyperchloremic metabolic acidosis
• prophylaxis and treatment of acute mountain sickness (dec. pH in acidosis, inc. ventilation)
• treatment glaucoma (dec CA activity in eye and dec. intraocular pressure)

Question 17

furosemide uses

Answer 17

-threshold concentration “ceiling dose”
-stimulates PG synthesis in lung and kidney
→NSAIDS may interfere with action
-rapid onset of action
-Edema
-tx of hypercalcemia
-tx mild hyperkalemia
-bromide, fluoride, iodide poisoning
-2nd line in combo with thiazides for HTN
-renal failure (inc. urine flow, enhance K excretion)

Question 18

HCTZ uses

Answer 18

• HTN and mild congestive heart failure
• edema (cirrhosis, renal disease)
• inc. excretion K and H
• dec. renal Ca excretion (Ca containing urinary stones)
• nephrogenic DI (reduce polyuria)
• adjunct to loop diuretic

Question 19

spironolactone uses

Answer 19

1. primary or secondary hyperaldosteronism, cirrhotic edema

Question 20

triamterine, amiloride uses

Answer 20

. Pts taking K+ wasting diuretic for HTN, treat hypokalemia

Question 21

mannitol uses

Answer 21

• Given IV, inc. water (and not Na) excretion
• prevention of acute renal failure after severe trauma/surgery
• promotes renal excretion of toxins

Question 22

vaptans uses

Answer 22

• hypervolemic and euvolemic hyponatremia

- manage SIADH when water restriction failed