pharmacology

Question 1

site of action of osmotic diuretics

Answer 1

PCT and descending loop of henle
slightly in collecting duct

Question 2

MOA of osmotic diuretics

Answer 2

inhibition of water and Na+ reabsorption

Question 3

site of action of carbonic anhydrase inhibitors

Answer 3

proximal tubules

Question 4

MOA of carbonic anhydrase inhibitors

Answer 4

inhibition of bicarbonate reabsorption

Question 5

site of action of loop diuretics

Answer 5

thick ascending limb of the loop of henle

Question 6

MOA of loop diuretic

Answer 6

inhibition of Na+, K+ and Cl-

Question 7

site of action of thiazide diuretics

Answer 7

early distal convoluted tubule

Question 8

MOA of thiazide diuretics

Answer 8

inhibition of Na+ Cl- co-transport

Question 9

site of action of K+ sparing diuretics

Answer 9

late DCT and collecting duct

Question 10

MOA of K+ sparing diuretics

Answer 10

inhibition of Na+ reabsorption and K+ secretion

Question 11

what is the role of the tubules in the nephron

Answer 11

reabsorption and secretion of substances and the formation of urine

Question 12

what is the role of the collecting duct

Answer 12

transfers urine to the medullary collecting duct

Question 13

where does the medullary collecting duct empty into

Answer 13

renal papillae in the renal pelvis

Question 14

what are the components of urinary excretion

Answer 14

filtration - reabsorption + secretion

Question 15

where is blood filtered in the nephron and how is this achieved

Answer 15

the glomerulus
passive transport of substances under pressure (due to blood pressure)

Question 16

what happens in reabsorption in the nephron

Answer 16

solutes and water are removed from tubular fluid and transported into the blood

Question 17

what happens in secretion in the nephron

Answer 17

solutes are transferred into the tubular fluid to be excreted

Question 18

how does secretion occur in the nephron

Answer 18

active transport

Question 19

what is natriuresis

Answer 19

the process of excretion of sodium in the urine

Question 20

what 3 substances promote natriuresis

Answer 20

VNP and ANP, calcitonin

Question 21

what substance inhibits natriuresis

Answer 21

aldosterone

Question 22

what is an important drug interaction to remember for loop diuretics

Answer 22

greater risk of digoxin toxicity due to hypokalaemia

Question 23

name a type of drug that reduces the efficacy of thiazides

Answer 23

NSAIDs

Question 24

name one type of drug that needs to be used with caution with potassium-sparing diuretics

Answer 24

ACE inhibitors

Question 25

name an osmotic diuretic

Answer 25

mannitol

Question 26

how do osmotic diuretics need to be given

Answer 26

IV infusion

Question 27

clinical indications for osmotic diuretics

Answer 27

prevention of AKI in conditions of reduced renal perfusion urgent treatment of intracranial and intraocular pressure

Question 28

name a condition that can cause reduced renal perfusion

Answer 28

rhabdomyolysis

Question 29

name 3 adverse effects of osmotic diuretics

Answer 29

transient expansion of blood volume hyponatraemia pulmonary oedema

Question 30

name a carbonic anhydrase inhibitor

Answer 30

acetazolamide

Question 31

what is the ending of a CA-I

Answer 31

zolamide

Question 32

where do carbonic anhydrase inhibitors act

Answer 32

proximal convoluted tubule of the nephron

Question 33

what is the MOA of CA-Is

Answer 33

reduces HCO3- reabsorption

Question 34

name an adverse effect of CAI's

Answer 34

metabolic acidosis

Question 35

name 2 loop diuretics

Answer 35

furosemide and bumetanide

Question 36

name some indications for thiazide diuretics

Answer 36

hypertension, heart failure, oedema, nephrotic syndrome

Question 37

name some contraindications for thiazide diuretics

Answer 37

hypotension, gout, renal failure, hypokalaemia

Question 38

what are the 2 main types of K+ sparing diuretics and give examples

Answer 38

aldosterone antagonists: spironolactone Na+ channel inhibitors: amiloride

Question 39

what makes adverse drug reactions more likely

Answer 39

polypharm, drugs with narrow therapeutic index, multimorbidity, frailty

Question 40

name some drugs with a narrow (<2) therapeutic index

Answer 40

warfarin, lithium, digoxin, carbamazepine, levothyroxine

Question 41

what classification is used for ADRs

Answer 41

ABCDEF

Question 42

what is a type A adverse drug reaction

Answer 42

augmented pharmacological effects - dose dependent and predictable

Question 43

which type of adverse drug reaction has the highest mortality/morbidity

Answer 43

type B - bizarre

Question 44

what are type C adverse drug reactions

Answer 44

chronic effects which result from prolonged therapy

Question 45

type B ADR from chloramphenicol

Answer 45

bone marrow aplasia

Question 46

type B ADR from halothane

Answer 46

hepatic necrosis

Question 47

how can we prevent type C ADRs

Answer 47

drug therapy monitoring

Question 48

name 3 examples of type C ADRs

Answer 48

- Cushing's disease from steroid therapy - Diabetes from beta blockers - hypertension from NSAIDs

Question 49

what are type D ADRs

Answer 49

delayed effects, often many years after stopping the drug

Question 50

give an example of a type D ADR

Answer 50

secondary malignancy post chemotherapy

Question 51

what are type E ADRs

Answer 51

end of treatment effects, can be due to abrupt withdrawal or rebound effects

Question 52

what are type F ADRs

Answer 52

failure of therapy

Question 53

what does it mean if a medication has a black triangle

Answer 53

still on a list of medicines subject to additional monitoring

Question 54

how often to black triangle medications get reviewed

Answer 54

every 2 years

Question 55

what is used to report adverse drug reactions

Answer 55

yellow card scheme