Pharm II - E1 L3

Question 1

Where does filtration occur?

Answer 1

renal tubule

Question 2

Where does reabsorption occur?

Answer 2

at various points

Question 3

How is Na reabsorbed?

Answer 3

ISOTONICALLY (water follows the Na) throughout the renal tubule (this is where diuretics work)

Question 4

Where does Acetazolamide work in the kidney?

Answer 4

Proximal tubule

Question 5

The inhibition of what by Acetazolamide causes inhibition of Na reabsorption, and excess HCO3- in the urine?

Answer 5

Carbonic Anhydrase

Question 6

Which drug causes alkaline urine + hyperchloremic metabolic acidosis?

Answer 6

Acetazolamide

Question 7

Cross sensitivity to sulfa is seen with which drugs?

Answer 7

Acetazolamide and possibly Lasix

Question 8

What are the clinical indications for Acetazolamide?

Answer 8

moderate-severe alkalosis, altitude sickness, diuresis for heart failure (also glaucoma, epilepsy, pseudotumor cerebri, central sleep apnea, to decr CSF formation and aqueous humor)

Question 9

What type of diuretic is mannitol?

Answer 9

Osmotic

Question 10

How does mannitol work?

Answer 10

limits passive H2O absorption that follows active Na reabsorption, incrs renal tubule osmolarity

DRAWS H2O from CELLS TO PLASMA

Question 11

What are some side effects of mannitol?

Answer 11

fluid overload/pulm edema, HYPOnatremia->HYPERnatremia

Question 12

Compartment syndrome is a risk with the extravasation of which diuretic?

Answer 12

Mannitol

Question 13

True or False. Mannitol is a renal protectant

Answer 13

FALSE. It may prevent acute injury in renal transplant but NO EVIDENCE for renal protection otherwise

Question 14

What type of diuretic is Lasix?

Answer 14

Loop

Question 15

How does Lasix work?

Answer 15

Prevents salt reabsorption in thick ascending loop of Henle by binding to the Cl- site

Question 16

What diuretic is the first line treatment for acute CHF?

Answer 16

Furosemide (Lasix) - relieves congestion, pulm edema, swelling and peripheral edema

Question 17

What are the side effects of Lasix?

Answer 17

Hypovolemia + diuresis can lead to renal injury and hypovolemia (decr global perfusion)

HYPOnatremia, kalemia, volemia

POSSIBLY OTO-TOXICITY

Question 18

The pneumonic OH DANG stands for what in regards to Lasix?

Answer 18

O- oto-toxicity
H- hypokalemia
D- dehydration
A- allergy sulfa?
N- nephritis
G- gout

Question 19

Which diuretic works at the distal convoluted tubule?

Answer 19

Thiazides (HCTZ)

Question 20

How does HCTZ work?

Answer 20

Block NaCl reabsorption, similar to Loop diuretics and excrete Na+, K+, Cl-, HCO3-

Question 21

What can HCTZ be a treatment for?

Answer 21

HTN, volume overload, pregnancy-associated edema

Question 22

These side effects are associated with which diuretic?: Hypokalemic hypochloremic metabolic alkalosis

Answer 22

HCTZ (Lasix sort of causes this too)

In addition: pancreatitis, hyperglycemia, diarrhea, aplastic anemia

Question 23

What are the K+ sparing diuretics?

Answer 23

Amiloride, triamterene, spironolactone

Question 24

Which of the following is/are distal collecting duct K+ sparing?
Amiloride
Spironolactone
Triamterene

Answer 24

amiloride and triamterene

Question 25

Which of the following is/are aldosterone antagonist K+ sparing?
Amiloride
Spironolactone
Triamterene

Answer 25

Spironolactone

Question 26

Which diuretic blocks epithelial Na+ channels to prevent Na reabsorption and inhibits K secretion into distal renal tubules?

Answer 26

Amiloride and triamterene

Question 27

What is the side effects associated with Amiloride and triamterene?

Answer 27

HYPOnatremia, HYPERkalemia

Question 28

How does Spironolactone work?

Answer 28

Inhibits Na reabsorption and causes K retention

Question 29

Which diuretic is an effective tx for volume overload with heart failure, cirrhosis?

Answer 29

Spironolactone

Question 30

What are common side effects associated with Spironolactone?

Answer 30

HYPOnatremia, HYPERkalemia, gynecomastia