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Nephrology > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Use of carbonic anhydrase inhibitors _ and _

A

Use of CA inhibitors acetazolamide and brinzolamide
* Prevention of altitude sickness
* Reducing intra-ocular pressure (glaucoma)
* Blocking CSF production to treat high intracranial pressure

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1
Q

Osmotic diuretics work primarily in _ region of the nephron

A

Osmotic diuretics work primarily in the PCT

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2
Q

Acetazolamide and brinzolamide indirectly exert their effect on _ transporter

A

Acetazolamide and brinzolamide indirectly exert their effect on Na/H exchanger via the blockade of carbonic anhydrase
* Block the reabsorption of HCO3-

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3
Q

CA inhibitor toxicities include _ and _

A

CA inhibitor toxicities include kidney stones (urine alkalization) and metabolic acidosis

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4
Q

Name 4 loop diuretics

A
  1. Ethacrynic acid
  2. Torsemide
  3. Bumetanide
  4. Furosemide
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5
Q

Loop diuretics block _

A

Loop diuretics block NKCC

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6
Q

Uses of loop diuretics include:

A

Loop diuretics:
* First line treatment for CHF (edema)
* Improving urine output for CKD
* Treating hyponatremia for SIADH
* Treating severe hyperkalemia, hypercalcemia

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7
Q

(Loop diuretics/ Thiazide diuretics) are more effective at treating primary hypertension

A

Thiazide diuretics are more useful for treating primary hypertension

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8
Q

Loop diuretic toxicities:

A

Loop diuretic toxicities:
1. Kidney stones (hypercalciuria)
2. Hypocalcemia
3. Hypomagnesemia
4. Metabolic alkalosis

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9
Q

Both loop and thiazide diuretics can cause _ kalemia and metabolic _

A

Both loop and thiazide diuretics can cause hypokalemia and metabolic alkalosis
* Due to the activation of RAAS

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10
Q

_ and _ are thiazide diuretics that function by inhibition of _

A

Hydrochlorothiazide and chlortalidone are thiazide diuretics that inhibit Na/Cl cotransporter

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11
Q

_ are the first line treatment for primary hypertension

A

Thiazides are the first line treatment for primary hypertension

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12
Q

Thiazides can be used for prevention of _ containing renal stones

A

Thiazides can be used for prevention of calcium-containing renal stones

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13
Q

Nephrogenic DI can also be treated with _

A

Nephrogenic DI can also be treated with thiazide diuretics

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14
Q

Thiazidue diuretics will cause _ calcium in the blood

A

Thiazidue diuretics will cause increased calcium in the blood
* Hypocalciuria also reduces the risk of kidney stones

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15
Q

Hyperuricemia/gout is a complication of _ diuretics

A

Hyperuricemia is a complication of thiazide diuretics
* Both compete with the OAT anion transporter for clearance

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16
Q

If hypokalemia becomes a concern with the use of a loop or thiazide diuretic, we can add on a _ diuretic

A

If hypokalemia becomes a concern with the use of a loop or thiazide diuretic, we can add on a potassium sparing diuretic

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17
Q

Spironolactone and eplerenone block _ in the CCD

A

Spironolactone and eplerenone block aldosterone in the CCD

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18
Q

Amiloride and triamterene block _ in the CCD

A

Amiloride and triamterene block ENaC

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19
Q

_ diuretics can cause a toxicity of hyperkalemia

A

Amiloride, triamterene, spironolactone, eplerenone are diuretics that can cause hyperkalemia as a side effect –> therefore they can cause type IV RTA

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20
Q

Spironolactone competes with testosterone and increases the conversion of testosterone to estradiol; therefore it can cause _ effects

A

Spironolactone competes with testosterone and increases the conversion of testosterone to estradiol; therefore it can cause gynecomastia, sexual dysfunction, low libido

21
Q

Osmotic agents such as _ are used to treat patients with high intracranial pressure

A

Osmotic agents such as mannitol are used to treat patients with high intracranial pressure

22
Q

Mannitol can cause fluid overload in cases of _

A

Mannitol can cause fluid overload in cases of renal impairment if the mannitol cannot be filtered through the glomerulus and stays in the blood

23
Q

Carbonic anhydrase inhibitors have _ effect on the brain

A

Carbonic anhydrase inhibitors decrease production of CSF

24
Q

Carbonic anhydrase inhibitors have _ effect on the eyes

A

CA inhibitors decrease production of aqueous humor
* Acetazolamide can be used for acute glaucoma (prevent the build up of aqueous humor)

25
Q

Carbonic anhydrase inhibitors create a _ pH in the urine

A

Carbonic anhydrase inhibitors create a basic urine
* Risk of kidney stones

26
Q

Acetazolamide causes _ type acid base disorder

A

Acetazolamide causes a proximal RTA (type 2)
* Blocks the reabsorption of bicarb in the PCT

27
Q

Aside from acidosis, carbonic anhydrase can also cause what other electrolyte abnormality?

A

CA inhibitors can cause hypokalemia
* Increased Na+ in the tubular fluid means more Na+ that tries to get reabsorbed in the DCT

28
Q

Mannitol and urea are two osmotic diuretics that work by increasing what starling force?

A

Mannitol and urea are two osmotic diuretics that work by increasing capillary oncotic pressure
* Increase in osmotic pressure/pull means less water is reabsorbed, increased urine output

29
Q

Osmotic diuretics can cause _ electrolyte abnormality

A

Osmotic diuretics can cause Na+ imbalances (hypo or hypernatremia)

30
Q

Why are osmotic diuretics contraindicated in HF patients?

A

Osmotic diuretics like mannitol draw fluid out of the tissue and into the intravascular space –> can worsen HF

31
Q

_ diuretics can decrease the reabsorption of calcium and magnesium

A

Loop diuretics can decrease the reabsorption of calcium and magnesium

32
Q

The diuretic of choice for treating hypercalcemia is _

A

The diuretic of choice for treating hypercalcemia is furosemide (or loop diuretic)

33
Q

Because furosemide contains a sulfa group, it poses a risk for _ type kidney damage

A

Because furosemide contains a sulfa group, it poses a risk for acute interstitial nephritis

34
Q

Loop diuretics may cause _ electrolyte abnormalities

A

Loop diuretics may cause..
* Hypokalemia
* Hypomagnesemia
* Hyperglycemia
* Hyperuricemia

35
Q

Why would loop diuretics contribute to hyperglycemia?

A

Loop diuretics induce hypokalemia –> less K+ decreases the release of insulin

36
Q

Name the thiazide diuretics

A

Name the thiazide diuretics:
* Hydrochlorothiazide
* Chlorothiazide
* Chlorthalidone
* Metolazone

37
Q

Thiazide diuretics increase Ca2+ reabsorption by stimulating _ channel

A

Thiazide diuretics increase Ca2+ reabsorption by stimulating Na+/Ca2+ exchanger

38
Q

_ diuretic can be prescribed for patients with recurrent calcium kidney stones

A

Thiazides can be prescribed for patients with recurrent calcium kidney stones
* The only diuretic that increases Ca2+ reabsorption so decreases Ca2+ content in the urine

39
Q

Thiazide diuretics can cause electrolyte abnormalities such as:

A

Thiazide diuretics can cause the following electrolyte abnormalities:
* Hypokalemia
* Hyponatremia
* Hyperglycemia
* Hyperlipidemia
* Hyperuricemia
* Hypercalcemia

40
Q

_ is the diuretic that can cause hyperlipidemia

A

Thiazides can cause hyperlipidemia

41
Q

Spironolactone and eplerenone are _ antagonists

A

Spironolactone and eplerenone are aldosterone antagonists

42
Q

Triameterene and amiloride are _ antagonists

A

Triameterene and amiloride are ENaC antagonists

43
Q

Eplerenone can cause _ acid base disorder

A

Eplerenone can cause metabolic acidosis
* Eplerenone is an aldosterone antagonist like spironolactone

44
Q

Triamterene and amiloride act in _ and _ regions of the nephron

A

Triamterene and amiloride act in the late DCT and the cortical collecting duct

45
Q

Conn syndrome can be treated with _

A

Conn syndrome can be treated with spironolactone
* Conn syndrome is hyperaldosteronism

46
Q

Spironolactone and amiloride can cause _ electrolyte imbalance

A

Spironolactone and amiloride can cause hyperkalemia

47
Q

ACE inhibitors block the conversion of _ to _

A

ACE inhibitors block the conversion of angiotensin I –> angiotensin II
* We will see high renin, high AT1, low AT2, low aldosterone

48
Q

ARBs are a drug class that inhibits _

A

ARBs are a drug class that inhibits angiotensin II receptor (AT1R)
* We will see high renin, high AT1, high AT2, low aldosterone

49
Q

Aliskiren works via _ mechanism

A

Aliskiren is a direct renin inhibitor
* We will see high renin, low AT1, low AT2, low aldosterone

Nephrology (16 decks)

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