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Cardio-Renal I Midterm > Pharmacology - Diuretics > Flashcards

Pharmacology - Diuretics Flashcards

1
Q

how can endothelial cell damage lead to high blood pressure

A

endothelial cells (healthy) would normally release nitric oxide - a vasodilator. if the endothelial cells are damaged, there will be no nitric oxide release and the arteries will become stiff and blood flow hindered - INCREASED RESISTANCE

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2
Q

increased load on the heart due to high BP can cause…

A

CHF

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3
Q

true or false

if HTN is asymptomatic, it does not need to be treated

A

FALSE i it does

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4
Q

name 3 classes of diuretics

A

thiazides
loop diuretics (high ceiling)
potassium sparing

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5
Q

MOA diuretics

A

act on the kidneys to increase excretion of sodium and water

this decrease in blood volume causes decreased blood pressure

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6
Q

name 2 thiazide diuretics

A

hydrochlorothiazide
chlorthalidone

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7
Q

name 2 high ceiling loop diuretics

A

furosemide and torsemide

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8
Q

name 3 potassium sparing diuretics

A

spironolactone
triamterene
amiloride

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9
Q

MOA ACE inhibitors

how to recognize them?

A

anything ending in “pril”

inhibits conversion angiotensin 1 to angiotensin 2 by inhibiting ACE enzyme

this causes decrease in vasoconstriction, reduces peripheral resistance, and lowers BP

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10
Q

what are AT1 blockers and what is their MOA

A

inhibit angiotension 2 binding to its receptor (AT1)
called “ARBS”
all end in “artan”

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11
Q

name 2 centrally acting antihypertensives and their MOA

A

clonidine, methyldopa

act (agonists) on CENTRAL alpha 2 receptors to decrease sympathetic outflow, and thus cause a fall in bp

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12
Q

true or false

a2 causes vasodilation so clonidine and methyldopa are agonists to it

A

true

a1 causes constriction

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13
Q

nonselective beta blocker

what is MOA

A

propranolol

binds beta adrenergic receptors and BLOCKS activity

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14
Q

explain how labetolol and carvedilol work

A

bind B1 receptor in heart and BLOCK IT — blocks firing of SA node and reduces heart rate

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15
Q

cardioselective beta blocker

A

metoprolol

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16
Q

verapamil class

A

calcium channel blocker (NON dihydro pyridine)

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17
Q

name 3 alpha adrenergic blockers and their MOA

A

prazosin, terasozin, doxasozin

block alpha adrenergic receptors in smooth muscle to cause vasodilation

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18
Q

explain MOA calcium channel blockers

A

block influx of calcium into smooth muscle cells —- reduced contraction – decreased BP

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19
Q

**name 4 thiazide diuretics

A

chlorthalidone
hydrochlorothiazide
indapamide
metolazone

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20
Q

thiazide diuretics can also be called…

A

naturetics

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21
Q

___ are also called water pills. why?

A

diuretics

bc they remove more water through the urine

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22
Q

some things diuretics can treat

A

hypertension
edema
heart failure

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23
Q

***where do thiazides work within the nephron?

A

DCT - distal convoluted tubule

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24
Q

***EXPLAIN the full mechanism of thiazide diuretics

A

directly block the reabsorption of sodium and chloride into the body at the 1st portion of the DCT

they do this by inhibiting a sodium/chloride symport cotransporter

by inhibiting sodium entry, calcium reabsorption is ENHANCED

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25
diuretics will _____: -sodium levels -potassium levels -calcium lvels
decreased sodium and potassium increased calcium levels
26
true or false thiazide diuretics enhance the excretion of sodium and chloride in the urine
true
27
thiazide diuretics DECREASE the urinary excretion of _______
calcium
28
true or false thiazide diuretics work in the collecting duct
FALSE - DCT
29
true or false thiazide diuretics increase calcium reabsorption
TRUE
30
thiazide diuretics cause ___ metabolic ____
hypokalemic metabolic alkalosis
31
molecular target of thiazide diuretics
the sodium/chloride symport cotransporter
32
true or false the sodium and potassium lost in the urine due to thiazide diuretics is a passive loss
true
33
*****5 contraindications for HCTZ and explain
-gout (bc uric acid levels will be elevated) -diabetes (elevates glucose) bc potassium needed to convert proinsulin to insulin, and diuretics deplete potassium -hypokalemia -sulfonamide allergy -renal failure
34
***_______ can occur when taking diuretics because diuretics cause sodium depletion, which increases _____ reabsorption
LITHIUM TOXICITY INCREASED LITHIUM REABSORPTION
35
**thiazide diuretics cause ____ kalemia what are the symptoms?
hypo muscle pain and fatigue
36
**thiazide diuretics cause ____ glycemia why
hyperglycemia potassium depletion -- no conversion of proinsulin to insulin
37
** thiazide diuretics cause _____ lipidemia
hyperlipidemia rise in LDL ---- risk of stroke
38
**thiazide diuretics cause _____ uricemia
hyperuricemia bc urate excretion is inhibited
39
****thiazide diuretics can cause sudden cardiac ____
DEATH bc of hypokalemia -- heart rate affected
40
all of the AE of thiazide diuretics listed are really only relevant when? what is conclusion that the JNC made********
at HIGH DOSES -- very minimal AE with low doses of 12.5-25 start low dose thiazide therapy in HTN. if this therapy fails, try another antihypertensive along with it. DO NOT INCREASE THE THIAZIDE DOSE!!!!!!!
41
___diuretics are to be given when there is severe hypertension with retention of body fludis
loop diuretics
42
*** thiazides can cause metabolic ________
ALKALOSIS
43
____ is thiazide like diuretic
chlorthalidone
44
true or false** chlorthalidone has a different MOA than thiazides
FALSE - same even tho thiazide like inhibits Na/Cl symporter at DCT
45
CV reaction to chlorthalidone
orthostatic hypotension
46
indapamide class
thiazide-like diuretic
47
metolazone class
thiazide-like diuretic
48
true or false potassium sparing diuretics and thiazide/thiazide-like diuretics cannot be used together
FALSE they can be used together to replenish potassium lost by thiazides
49
other than _____, potassium sparing diuretics are primarily used with thiazide diuretics
other than spironolactone
50
"a class of drugs that helps the body to get rid of excess sodium and water without losing potassium in the urine"
potassium sparing diuretics
51
true or false k+ sparing diuretics have a different MOA than thiazide and thiazide-like diuretics
TRUE
52
name 4 potassium sparing diuretics
amiloride eplerenone spironolactone triamterene
53
amiloride inhibits ____
enac blocks epithelial sodium channel in the DCT
54
besides amiloride, what other drug inhibits enac
triamterene
55
____ is the metabolite of spironolactone and has the same MOA
eplerenone
56
potassium sparing diuretics work where in the nephron?
the collecting duct
57
explain how aldosterone antagonists like spironolactone and eplerenone work
normally, aldosterone would bind its receptor and work to retain water however, aldosterone antagonists bind the aldosterone receptor instead
58
the expression of enac channels is regulated by what?
aldosterone
59
potassium sparing diuretics can cause ___ kalemia and ____osis
hyperkalemia and acidosis
60
true or false aldosterone increase enac expression
TRUE more enac expression = more sodium influx and more water retained
61
true or false aldosterone antagonists cause a loss of sodium and water
true
62
3 major advantages of spironolactone over HCTZ
no hypokalemia, hyperglycemia, hyperuricemia
63
**2 major AE of potassium sparing diuretics like spironolactone
hyperkalemia metabolic acidosis
64
*****metabolite of spironolactone when is its use beneficial?
eplerenone in liver failure! it bypasses hepatic metabolism
65

Cardio-Renal I Midterm (14 decks)

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