Renal

Question 1

Mannitol

Answer 1

1) Use: Shock, drug overdose, increased ICP
2) Class/MOA: Osmotic diuretic, acts in PCT to increase tubular fluid osmolarity and increase urine flow. Decreases ICP
3) Side effects/ADEs: Pulmonary edema, dehydration, CHF, contraindicated in anuria
4) Fun Facts:

Question 2

Acetazolamide

Answer 2

1) Use: Glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness
2) Class/MOA: Carbonic anhydrase inhibitor, prevents bicarb reabsorption in PCT
3) Side effects/ADEs: hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy-You want to take SNAACs with you on your mountain expedition!Sulfa, Nephropathy/Parasthesias, Acidosis, Ammonia tox, (hyper)chloremia

Question 3

Furosemide

Answer 3

1) Use: Edema (CHF, cirrhosis, nephrotic syndrome, pulmonary edema), HTN, hypercalcemia2) Class/MOA: Loop diuretic. Inhibits cotransport system (Na, K, 2Cl) of thick ascending limb, preventing hypertonicity of the medulla. Stimulates PGE release for vasodilation of afferent arteriole.. Increases calcium release.
3) Side effects/ADEs: OH DANG! (Ototoxicity, hypokalameia, dehydration, allergy-sulfa, nephritis (interstitial), gout)

Question 4

Ethacrynic acid

Answer 4

1) Use: Diuresis for people with sulfa allergies2) same as Furosemide but it’s NOT a sulfa drug3) Side effects/ADEs: OH DANG! (Same as furosemide)4) Fun Facts: Same MOA as furosemide. Can cause hyperuricemia (never use in gout)

Question 5

Hydrochlorothiazide

Answer 5

1) Use: HTN, CHF, idiopathic hypercalciuria, nephrogenic DI (causes hypovolemia to induce Na/H20 reabsorption)
2) Class/MOA: Inhibits NaCl reabsorption in early DCT, limiting diluting capacity. Decrease calcium excretion.
3) Side effects/ADEs: HyperGLUC (hyperglycemia, hyperlipidemia (cholesterol, LDL), hyperuricemia, hypercalcemia). Hypokalemic matabolic alkalosis, hyponatremia
4) Sulfa drugs

Question 6

Spironolactone

Answer 6

1) Use: Hyperaldosteronism, K+ depletion, CHF2) Class/MOA: K+ sparing diuretic. Spironolactone is a competitive aldosterone receptor antagonist in cortical collecting duct. 3) Side effects/ADEs: Hyperkalemia (arrhythmias), endocrine effects (gynecomastia and other androgen effects)4) Fun Facts: The K+ STAys (Spironolactone, triamterene, amiloride)

Question 7

Triamterene

Answer 7

1) Use: Hyperaldosteronism, K+ depletion, CHF2) Class/MOA: K+ sparing diuretic. Triamterene and amiloride block Na channel in CCT. 3) Side effects/ADEs: Hyperkalemia (arrhythmias)4) Fun Facts: The K+ STAys (Spironolactone, triamterene, amiloride)

Question 8

Amiloride

Answer 8

1) Use: Hyperaldosteronism, K+ depletion, CHF2) Class/MOA: K+ sparing diuretic. Triamterene and amiloride block Na channel in CCT. 3) Side effects/ADEs: Hyperkalemia (arrhythmias)4) Fun Facts: The K+ STAys (Spironolactone, triamterene, amiloride)

Question 9

Captopril

Answer 9

1) Use: HTN, CHF, diabetic renal disease, prevent heart remodeling from HTN2) Class/MOA: Inhibit ACE to reduce angiotensin II. Renin release increases3) Captopril’s a CATCHH (Cough, Angiodema, Teratogen - renal malformation, Creatinine incr decr GFR, Hyperkalemia, 1st doseHypotension).Avoid in BL renal artery stenosis4) Fun Facts: ATII receptor blockers (sartans) are similar to these without the cough.

Question 10

Enalapril

Answer 10

1) Use: HTN, CHF, diabetic renal disease, prevent heart remodeling from HTN2) Class/MOA: Inhibit ACE to reduce angiotensin II. Renin release increases3) Captopril’s a CATCHH (Cough, Angiodema, Teratogen - renal malformation, Creatinine incr decr GFR, Hyperkalemia, 1st dose Hypotension).Avoid in BL renal artery stenosis4) Fun Facts: ATII receptor blockers (sartans) are similar to these without the cough.

Question 11

Lisinopril

Answer 11

1) Use: HTN, CHF, diabetic renal disease, prevent heart remodeling from HTN2) Class/MOA: Inhibit ACE to reduce angiotensin II. Renin release increases3) Captopril’s a CATCHH (Cough, Angiodema, Teratogen - renal malformation, Creatinine incr decr GFR, Hyperkalemia, 1st dose Hypotension).Avoid in BL renal artery stenosis4) Fun Facts: ATII receptor blockers (sartans) are similar to these without the cough.

Question 12

Eplerenone

Answer 12

1) Use: Hyperaldosteronism, K+ depletion, CHF2) Class/MOA: K+ sparing diuretic. Spironolactone is a competitive aldosterone receptor antagonist in cortical collecting duct. 3) Side effects/ADEs: Hyperkalemia (arrhythmias)4) Fun Facts: The K+ STAys (Spironolactone, triamterene, amiloride)