Pharmacology (Kidneys, Diuretics & Birth Control) Flashcards
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
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
E. Zona glomerulosa of adrenal cortex
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
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
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)
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
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
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
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
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
D. Gestational diabetes insipidus
Vasopressin is used to treat neurogenic and gestational
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
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
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
_______ is the synthetic analog of vasopressin.
Desmopressin
Where is Aldosterone secreted from?
A. Hippocampus
B. Hypothalamus
C. Anterior pituitary
D. Posterior pituitary
E. Adrenal cortex
E. Adrenal cortex
note: specifically the Zona glomerulosa of the adrenal cortex
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
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
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
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
______ is an antihypertensive drug that is a direct renin inhibitor via the RAAS pathway.
Aliskiren
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
“minipill” = “Micro, Nor, Or”
- Micronor
- Nor-Q.D.
- Orvette
note: if you just remember Micronor 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
Sildenafil and Tadalafil 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
