r e n a l p h a r m

Question 1

what are loop diuretics, give examples

Answer 1

furosemide, bumetanide, torsemide

inhibits NaKCl transporter in Loop of henle

Question 2

what are the main indications for loop diuretics

Answer 2

fluid overload

Question 3

describe the metabolism and excretion of loop diuretics

Answer 3

liver and kidney metabolism

excretion via urine

Question 4

what are the common side effects of loop diuretics

Answer 4

Hyponatraemia, hypokalaemia, diuresis, dehydration, alkalosis

Question 5

what are other important info about loop diuretics

Answer 5

Furosemide 40mg as same potency as 1mg Bumetanide

IV may be better absorbed if gut oedema present

Protein-bound = low volume of distribution

Question 6

what are carbonic anhydrase inhibitors and examples

Answer 6

Acetazolamide, Brinzolamide

act by inhibiting carbonic anhydrase

Question 7

what are the main indications for carbonic anhydrase inhibitors

Answer 7

glaucoma

benign intracranial HTN

Question 8

what are the common side effects of carbonic anhydrase inhibitors

Answer 8

Flushing, metabolic acidosis, agranulocytosis, liver failure

Question 9

what are the other important info around carbonic anhydrase inhibitors

Answer 9

Increased renal excretion of Na, K, HCO3 and H2O

Question 10

give example of thiazide/thiazide like diuretics

and MOA

Answer 10

Bendroflumethiazide, Indapamide,

Inhibits sodium chloride in DCT

Question 11

describe metabolism and excretion of thiazide and thiazide like diuretics

Answer 11

metabolised via kidneys

excreted via urine

Question 12

what are the common side effects of thiazide and thiazide like diuretics

Answer 12

Hyponatraemia, Hypokalaemia, Dehydration, Hypercalcaemia, Hyperuricaemia, Hypomagnesaemia, Alkalosis

Question 13

what are k sparing diuretics, name the groups

Answer 13

aldosterone antagnosists = Spironolactone

Epithelial Na channel blockers = Amiloride

Question 14

what are the main indications for thiazide and thiazide diuretics

Answer 14

HTN, fluid overload

Question 15

what are the main indications for K sparing diuretics

Answer 15

K-losing tubulopathies
Hypertension
Heart failure

Question 16

describe the MOA of K sparing diuretics

Answer 16

lock epithelial Na channel

Antagonises the action of aldosterone at mineralocorticoid receptors

Question 17

what are the common SE of K sparing diuretics

Answer 17

Hyperkalaemia Gynaecomastia

Question 18

what are examples and mode of action of glucocorticoid/corticosteroids

Answer 18

Prednisolone (PO), Hydrocortisone (IV/IM), Dexamethasone (PO/IV),

alters gene transcription

Question 19

describe the metabolism and excretion of glucocorticoid

Answer 19

liver metabolism

urine excretion

Question 20

what are the side effects of glucocorticoids

Answer 20

drenal suppression (especially courses > 3 weeks),

hyperglycaemia

psychosis, insomnia, indigestion, mood swings

Question 21

what are other SE associated with glucocorticoid

Answer 21

Diabetes, cataracts, glaucoma, peptic ulceration, susceptibility to infections, osteoporosis, muscle wasting, skin thinning, Cushingoid appearanc

Question 22

what are important things to remember in using corticosteroids

Answer 22

may need PPI (reduce GORD), Bisphosphonates (bone protection) and steroid card. Used both in short- term and long-term. Long-term steroid courses should NOT be withdrawn abruptly.