Pharm Exam

Question 1

What is the mechanism of action for acetazolamide?

Answer 1

it is a carbonic anhydrase inhibitor

It works on the proximal tubule to inhibit Hydrogen ion and Bicarbonate generation from O2 and Water

—> it decreased activity of NA/H exchanger

Question 2

What are the side effects of acetazolimide?

Answer 2

Acetazolamide can cause

1) Metabolic alkylosis — decreased production of HCO3
2) Hypokalemia — OCCURS DOWN STREAM –> sodium drives loss of K through the sodium-potassium ATPase in the principle cells

Question 3

Name the 4 loop diuretics

Answer 3

Furosemide
Bumetidine
Torsemide
Ethacrynic acid

Question 4

What channel do loops diuretics work on

Answer 4

NA-K-CL symporter

Question 5

How do loop diuretics cause hypokalemia?

Answer 5

Hypokalemia– downstream secretion in NA-K transporter

worsened by subsequent EBV—-> RAAS —> upregulation of NA/K atpase

DO NOT USE THESE ON PATIENTS WITH HEART CONDITIONS

Question 6

What are the 4 toxs of loops?

Answer 6

Hypokalemia,
Hypercalcuria,
Hyperuremia,
Metabolic Alykylosis

Question 7

How do loop diuretics cause hypercalcurIa?

Answer 7

DIFFICULT TO UNDERSTAND

1) nakcl symporter makes cell more positive
2) potassium leaks back into lumen of nephron
3) calcium in lumen moves toward negatively charged serum

Everything becomes opposite when symporter is blocker —–> excess calcium in urine (kidney stones)

Question 8

How do loops cause hyperuricemia?

Answer 8

diuretics compete with ureate for clearance (oat 1 and 2)

ALSO… antiporter reabsorbs urate and secretes diuretics…

both cause hyperurecemia

Question 9

What are the side effects of thiazides?

Answer 9

Hypokalemia 
Hypocalceuria/Hypercalcemia
Hyperuricemia 
Metabolic alkilosis 
Hyperglycemia

Question 10

Which diuretic is associated with hyerglycemia and diabetes?

Answer 10

thiazides

Question 11

what is the mechanism of action of triamterene and amiloride?

Answer 11

They are enac inhibitors/

Question 12

What are the side effects for enac inhibitors

Answer 12

HYPERKALEMIA— if sodium cannot pass through the EnAC, potassium cannot be excreted the rom K channel!!!

METABOLIC ACIDOSIS- no enac activity, no H+ secretion in H atpase channnel

Question 13

Name the aldosterone receptor antagonists

Answer 13

spirinolactone and eplirinone

Question 14

side effects of Aldo R?

Answer 14

hyperkalemia, metabolic acidosis, gynecomastia

Question 15

What is the osmotic diuretic and what are its side effects?

Answer 15

Mannitol— filterered, BUT NOT secreted or reabsorded. concentrates in urine

HYPOKALEMIA AND METABOLIC alkylosis—-> by increased H20 in lumen, it dilutes k and h in urine, draws them in from blood

Question 16

How do loops cause met alkylosis?

Answer 16

decreased EBV, increased RAAS, increased H channels, loss of H