REN drugs Flashcards

1
Q

What drug blocks hydrogencarbonate absoption

A

Acetazolamide

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2
Q

Where in the kidneys does Acetazolamide target

A

Acts mainly in the proximal tubule

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3
Q

How does acetazolamide work

A

Blocks carbonic anhydrase

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4
Q

Can acetazolamide be used a direuetic

A

Yes, it is a weak one
acts in later parts of tubule, and can retain the bicarbonate

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5
Q

What are the uses of acetazolamide

A

glaucoma, mountain sickness prophylaxis

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6
Q

Why do we use acetazolamide for altitude sickness

A

-the drug can cause metabolic acidosis
-because when we are at altitude
-we get respiratory alkalosis because the partial pressure of o2, is lower
-so we ventilate more
-in doing so we lose co2.
-Anyways we give this before you climb a mountain because this causes acidosis
-which will counteract with alkalosis caused by high altitude

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7
Q

What is a problem with acetazolamide

A

The pH of urine will become alkaline → leading to metabolic acidosis

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8
Q

Does caffine have a diuretic effect

A

Yes

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9
Q

How does caffine have a diuretic effect

A

it works on the adenosine recpetor

so if increase GFR, we inhibit sodium ion reabsoption, so we get a diuresis

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9
Q

Name a widely used potent diuretic

A

Furosemide

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9
Q

How does furosemide work

A

Acts in the ascending limb of Loop of Henle (so its a “loop” diuretic)

  • Blocks Na+/K+/2Cl- co-transporter
    • stops salt moving, so stops water being rebasoped,
    • which causes diuresis
  • Allows up to 20% of filter Na+ to be excreted, causing enormous natriuresis (losing sodium) and diuresis.
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10
Q

Why do we use furosemide

A

Uses: cardiac failure, renal failure

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11
Q

What are the side effetcs of furosemide

A
  • K+ loss (and subsequent hypokalemia), leading to cardiac dysrhythmias (particularly when administered with digoxin)
  • CVS: link prolong time for AP, so that (check that out)

Other side effects:

  • Hypovolaemia (assessed by acute weight changes)
  • Mild metabolic alkalosis (distal Na+/H+ exchange)
  • Loss of Mg2+ and Ca2+ (loss of filtrate +ve charge).
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12
Q

What do Thiazides do

A
  • Block Na+/Cl- co-transporters
  • stops ions from being reabsorbed, which means less water is reabsorbed
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13
Q

Where do thiazides work

A

Act in the distal tubule

its a moderately effective diuretics

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14
Q

Why do we use thiazides

A
  • Uses:antihypertensive
    • As a diuretic, in conjunction with furosemide
15
Q

What are the side effects of thiazides

A
  • increased uric acid
  • Hyperglycaemia
  • Hyponatraemia
16
Q

What do we use spironolactone for

A

we use it to block the effects of aldosterone

17
Q

Where does Spironolactone act

A

Acts in the Collecting tubules and ducts

18
Q

When we would prescribe spironolactone

A

heart failure (K+ sparing diuretic)

19
Q

What are the sides effects of spironolactone

A

Gynaecomastia
menstrual disorders, testicular atrophy hyperkalaemia

20
Q

What drug is newer than spironolactone

A

Eplerenone

mineralocorticoid inhibitor but expensive

21
Q

What is the mechanism of aquaretic drugs

A
  • ## Causes water loss without salt lossHow
    -Acts onV2 receptor as antagonists (Vaptans; e.g tolvaptan)
21
Q

What are Aquaretic drugs used to treat

A

used to treat chronic hyponatraemia (low sodium levels)
-SIADH

22
Q

Where do Aquaretic drugs act on in the kidneys

A

Late portion of the distal tubule and the collecting duct to block the action of AVP (vasopressin or ADH)

23
Q

How do we inhibit the renin-angiotensin system to control blood pressure

he asked an MCQ about one of these drugs

A
  • ACE inhibitors
  • Angiotensin 1 receptor antagonists
  • Aldosterone receptor antagonists
  • Renin inhibition
24
Q

What drugs inhibit ACE

A

captopril, enalopril

25
Q

What drugs inhibit the AT1 receptor

A

candesartan, irbesartan

26
Q

What drug inhibits aldosterone

A

spironolactone

27
Q

What drug inhibits renin

A

aliskiren