Discuss diabetes insipidus: what does it cause an imbalance of? what symptoms do pts experience?

Diabetes Insipidus NOT related to diabetes mellitus causes imbalance of fluids in the body Pts are continuously thirsty causing them to urinate a lot

Pharmacology (Kidneys, Diuretics & Birth Control) Flashcards by Gavin Kallabat

Where is ADH secreted from?

A. Hippocampus

B. Anterior pituitary

C. Posterior pituitary

D. Zona fasiculata of adrenal cortex

E. Zona glomerulosa of adrenal cortex

C. Posterior pituitary

Hypothalamus = synthesizes ADH

Posterior pituitary = secretes ADH

Collecting duct = where ADH acts at

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Where is aldosterone secreted from?

A. Hippocampus

B. Anterior pituitary

C. Posterior pituitary

D. Zona fasiculata of adrenal cortex

E. Zona glomerulosa of adrenal cortex

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Where is ADH synthesized?

A. Hypothalamus

B. Anterior pituitary

C. Posterior pituitary

D. Zona fasiculata of adrenal cortex

E. Zona glomerulosa of adrenal cortex

A. Hypothalamus

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Where does ADH act?

A. Blood vessels

B. Proximal tubule

C. Loop of Henle

D. Distal tubule

E. Collecting duct

F. A and E

E. Collecting duct

ADH:

also known as vasopressin
insertion of aquaporins in membrane of collecting duct
causes sytemic vasoconstriction
increases BP by increasing fluid volume
used for cardiogenic shock and diabetes insipidus

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Cardiogenic shock can result in hypotension (low BP). ______ causes vasoconstriction, which leads to an increase in BP thus can be treatment for cardiogenic shock.

Vasopressin

note: causes systemic vasoconstriction (“Vasopressin”)
* suppresses blood vessels (vaso-pressin)

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Vasopressin is used to treat all of the following EXCEPT:

A. Neurogenic diabetes insipidus

B. Nephrogenic diabetes insipidus

C. Cardiac shock

D. Gestational diabetes insipidus

B. Nephrogenic diabetes insipidus

Vasopressin is used to tx:

Cardiac shock
neurogenic diabetes insipidus
gestational diabetes insipidus

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Discuss diabetes insipidus:

what does it cause an imbalance of?
what symptoms do pts experience?

Diabetes Insipidus

NOT related to diabetes mellitus
causes imbalance of fluids in the body
Pts are continuously thirsty causing them to urinate a lot

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Which of the following types of diabetes insipidus is characterized by a problem with receptors in the kidney?

A. Neurogenic diabetes insipidus

B. Nephrogenic diabetes insipidus

C. Dipsogenic diabetes insipidus

D. Gestational diabetes insipidus

B. Nephrogenic diabetes insipidus

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Which of the following types of diabetes insipidus can be a result of injury to the posterior pituitary?

A. Neurogenic diabetes insipidus

B. Nephrogenic diabetes insipidus

C. Dipsogenic diabetes insipidus

D. Gestational diabetes insipidus

A. Neurogenic diabetes insipidus

Neurogenic = posterior pituitary

Nephrogenic = kidney

Dipsogenic = hypothalamus

Gestational = pregnancy

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Which of the following types of diabetes insipidus may occur during pregnancy?

A. Neurogenic diabetes insipidus

B. Nephrogenic diabetes insipidus

C. Dipsogenic diabetes insipidus

D. Gestational diabetes insipidus

Vasopressin is used to treat neurogenic and gestational

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Which of the following types of diabetes insipidus is due to a malfunction of the thirst mechanism in the hypothalamus?

A. Neurogenic diabetes insipidus

B. Nephrogenic diabetes insipidus

C. Dipsogenic diabetes insipidus

D. Gestational diabetes insipidus

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Which of the following is vasopressin used to treat?

A. Neurogenic diabetes insipidus

B. Nephrogenic diabetes insipidus

C. Dipsogenic diabetes insipidus

D. Gestational diabetes insipidus

E. B and D

F. A and D

G. A and C

F. A and D

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Which of the following is Desmopressin used to treat?

A. Neurogenic diabetes insipidus

B. Nocturnal enuresis

C. Dipsogenic diabetes insipidus

D. Nocturia

E. A, B and D

F. All of the above

E. A, B and D

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_______ is the synthetic analog of vasopressin.

Desmopressin

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Where is Aldosterone secreted from?

A. Hippocampus

B. Hypothalamus

C. Anterior pituitary

D. Posterior pituitary

E. Adrenal cortex

note: specifically the Zona glomerulosa of the adrenal cortex

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Discuss the pathway of Aldosterone:

Aldosterone

Summary:

Low BP or high K⁺ signals the adrenal cortex to release aldosterone
Aldosterone acts on P cells of the collecting duct
This causes and increase in Na⁺ reabsorption and K⁺secretion

Low blood pressure activates the RAS pathway which in turn signals the adrenal cortex to release Aldosterone
High K⁺ in plasma directly signals the adrenal cortex to release Aldosterone
Adrenal cortex secretes Aldosterone to P cells of the collecting duct
This causes an increase of Na⁺ reabsorption and an increase of K⁺ secretion

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What part of the nephron does vasopressin and aldosterone act on?

Collecting duct

Vasopressin = insertion of aquaporins in the membrane of the collecting duct

Aldosterone = acts on P cells of the collecting duct

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How do each of the following effect blood pressure?

Vasopressin
Aldosterone

Vasopressin and Aldosterone INCREASE BP

Vasopressin:

causes systemic vasoconstriction = increases BP
causes water retention = increasing fluid volume = increases BP

Aldosterone:

causes P cells to reabsorb more Na⁺ = increase in BP
causes P cells to secrete more K⁺ = increase in BP

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All of the following antihypertensive drugs work via the RAAS pathway EXCEPT:

A. Alpha1-blockers

B. Diuretics

C. ACE inhibitors

D. Angiotensin II blockers

E. Direct renin inhibitors

F. Beta-blockers

A. Alpha1-blockers

Antihypertensive drugs involved in the RAAS pathway:

Diuretics
ACE inhibitors
Angiotensin II blockers
Direct renin inhibitors (Aliskiren)
Beta-blockers

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______ is an antihypertensive drug that is a direct renin inhibitor via the RAAS pathway.

Aliskiren

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Which of the following inhibits renin release?

A. Diuretics

B. ACE inhibitors

C. Beta-blockers

D. Alpha1-blockers

E. Angiotensin II blockers

C. Beta-blockers

______ decrease plasma and extracellular fluid volumes which in turn decreases preload, cardiac output and total peripheral resistance.

Diuretics

What is the overall effect of diuretics on blood pressure?

Decreased workload of the heart, which decreases BP

Which of the following diuretics work on the distal tubule?

A. Thiazides

B. Loop diuretics

C. K⁺ sparing diuretics

D. A and C

E. All of the above

D. A and C

Loop diuretics = Ascending loop of henle

All of the following diuretics work at the distal tubule on the Na⁺/Cl^- cotransporter (**NCC**) EXCEPT: A. Hydrochlorothiazide B. Chlorthalidone C. Furosemide D. Chlorothiazide

C. Furosemide "Thiazides" = NCC Loop diuretics = NKCC

All of the following can be caused by benzothiadiazides (thiazides) EXCEPT: A. Hyperkalemia B. Hyponatremia C. Hypokalemia D. Reduced Ca²⁺ excretion E. Increased plasma uric acid

A. Hyperkalemia "Thiazides" are NOT K⁺sparing

All of the following diuretics work in the ascending loop of henle to block the Na⁺/K⁺/2Cl^- (NKCC) transporter from reabsorbing ions from the tubule EXCEPT: A. Furosemide B. Torsemide C. Chlorthalidone D. Bumetanide

C. Chlorthalidone **Hydrochlorothiazide, Chlorothiazide, Chlorthalidone = NCC** (Na/Cl cotransporter) **Furosemide, Bumetanide, Torsemide = NKCC** (Na/K/2Cl transporter)

Which of the following are K⁺-sparing diuretics? A. Furosemide B. Torsemide C. Chlorthalidone D. Bumetanide E. Amiloride

E. Amiloride K⁺-sparing = Amiloride and Triamterene

Which of the following are K+-sparing diuretics? A. Furosemide B. Torsemide C. Triamterene D. Bumetanide

C. Triamterene

Which of the following block aldosterone regulated effects in the late distal tubule/early collecting duct? A. Torsemide B. Amiloride C. Hydrochlorothiazide D. Furosemide

B. Amiloride K⁺-sparing diuretics: block aldosterone * blocks Na⁺ reabsorption and increase K⁺ reabsorption

K⁺-sparing diuretics can cause which of the following? A. Hyperkalemia B. Hyponatremia C. Hypokalemia D. Reduced Ca2+ excretion

A. Hyperkalemia

Which of the following diuretics is similar to K⁺-sparing diuretics but are **true antagonist of the aldosterone receptor**? A. Spironolactone B. Triamterene C. Furosemide D. Hydrochlorothiazide

A. Spironolactone **Eplerenone** is also similar to K⁺-sparing diuretics and is another true antagonist of the aldosterone receptor

Which of the following diuretics is similar to K+-sparing diuretics but are **true antagonist of the aldosterone receptor**? A. Chlorthalidone B. Triamterene C. Furosemide D. Hydrochlorothiazide E. Eplerenone

E. Eplerenone

\_\_\_\_\_\_ combined with diuretics may result in decreased diuretic activity, ultimately increasing blood pressure.

NSAIDs

Careful when prescribing NSAIDs for a patient on diuretics because it can cause blood pressure to \_\_\_\_\_. A. Increase B. Decrease

A. Increase

All of the following are used for post-menopausal hormone replacement therapy EXCEPT: A. Estradiol (Estrace) B. Norethindrone (Aygestin) C. Premarin D. Estropipate (Ogen)

B. Norethindrone (Aygestin) **Medroxyprogesterone (Provera), and Norethindrone (Aygestin) are used to deminish the side effects of estrogen therapies**

All of the following oral contraceptives are a combination of estrogen and progestin EXCEPT: A. Loestrin B. Ovocon C. Orvette D. Levora E. Nordette

C. Orvette "LOL Nordette" **_Combination of estrogen and progestin:_** * Loestrin * Ovocon * Levora * Nordette **_"Minipill" (progestin ONLY):_** * Micronor * Nor-Q.D. * Orvette

All of the following oral contraceptives contain progestin ONLY ("micropill") EXCEPT: A. Micronor B. Nor-Q.D. C. Orvette D. Levora

D. Levora "**_mini_**pill" = "_Micro_, Nor, Or" * Micronor * Nor-Q.D. * Orvette note: if you just remember **Micro**_nor_ you can remember 2 of them. **Micronor** and _Nor_-Q.D. because Micronor has both in its name alone.

Which of the following is and emergency contraceptive known as Plan B? A. Micronor B. Levnorgestrel C. Orvette D. Levora E. Loestrin

B. Levnorgestrel Plan B (Levnorgestrel) side effect is an increased risk of thromboembolism

Which of the following is a uterine stimulant that stimulate uterine smooth muscle contraction? A. Oxytocin B. Ergonovine C. Terbutaline D. Ritodrine E. A and B F. C and D

E. A and B Oxytocin and Ergonovine induce labor

Which of the following is a uterine relaxant that is a Beta2 adrenergic receptor agonist? (delays labor) A. Oxytocin B. Ergonovine C. Terbutaline D. Ritodrine E. A and B F. C and D

F. C and D Uterine Relaxants: * Uterine relaxants are called "Tocolytics" * Inhibit uterine smooth muscle contraction * Delay labor * Beta2 adrenergic receptor agonist * **Terbualine** and **Ritodrine**

Which of the following are also known as "Tocolytics"? A. Oxytocin B. Ergonovine C. Terbutaline D. Ritodrine E. A and B F. C and D

F. C and D "Oxytocics" = Oxytocin and Ergonovine "Tocolytics" = Terbutaline and Ritodrine

Which of the following are also known as "Oxytocics"? A. Ritodrine B. Terbutaline C. Ergonovine D. Oxytocin E. A and B F. C and D

F. C and D

Which of the following is an infertility agent that promotes maturation of ovarian follicles? A. Ritodrine B. Clomiphene C. Ergonovine D. Oxytocin

B. Clomiphene Infertility agents = **Clomiphene** and **Urofollitropin**

Which of the following is an infertility agent that promotes maturation of ovarian follicles? A. Urofollitropin B. Levnorgestrel C. Ergonovine D. Oxytocin E. Levora

A. Urofollitropin Infertility agents = **Clomiphene** and **Urofollitropin**

Which of the following is a male reproductive agent used for testosterone replacement? A. Urofollitropin B. Levnorgestrel C. Ergonovine D. Fluoxymesterone E. Levora

D. Fluoxymesterone Testosterone replacement drugs = **Methyltestosterone** and **Fluoxymesterone**

Which of the following is a male reproductive agent used for testosterone replacement? A. Methyltestosterone B. Levnorgestrel C. Ergonovine D. Finasteride E. Levora

A. Methyltestosterone

Which of the following is a male reproductive agent used to treat benign prostatic hypertrophy (BPH)? A. Methyltestosterone B. Sildenafil C. Ergonovine D. Finasteride E. Levora

D. Finasteride note: benign prostatic hypertrophy (BPH) is a condition where the prostate is enlarged. Finasteride inhibits 5-alpha-reductase, the enzyme that converts testosterone to dihydrotestosterone

Which of the following is a male reproductive agent used to treat **erectile dysfunction**? A. Methyltestosterone B. Sildenafil C. Ergonovine D. Finasteride E. Levora

B. Sildenafil Sildena**fil** and Tadala**fil** are both used for erectile dysfunction (they **fil** the dick up)

Which of the following is a male reproductive agent used to treat erectile dysfunction? A. Methyltestosterone B. Tadalafil C. Ergonovine D. Finasteride E. Levora

B. Tadalafil Tadaaa!!!! your dick is working