Renal

Question 0

Furosemide

Answer 0

cotransporter Na/K/2Cl of thicke ascending limb
stimulate PG
inhibited by NSAID
urine: increase Na, K, Ca,Mg,Cl
Blood: HCO-
toxicity:ototoxicity, Allergy, interstitial nephritis, Gout
use: CHF, cirrhosis, nephrotic, syndrome, pulmonary edema,HTN

Question 1

Acetazolamide

Answer 1

inhibition of CA in PCT

urine: increase Na K
blood: increase H, Cl, NH3
use: glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness, pseudotumor

Question 2

Ethacrynic acid

Answer 2

inhibition of Na/Cl/K
phenoxyacetic acid derivative
used in those allergic to sulfa
blood:increase uricemia, decrease Ca

Question 3

Hydrochlorothiazide

Answer 3

inhibits NaCl reaborption in early distal tubule
HTN, CHF, hypercalsiuria, nephrogenic diabetes insipidus
urine: increase K, H, Na
blood: increase Glu, Lipid, Uricemia, Calcemia
该糖尿要指检

Question 4

spironolactone

Answer 4

competitive aldosterone receptor antagonist in cortical collecting tubule
Hyper aldosteronism, K depletion, CHF
blood: increase K,H, endocrine effect for spironolactone

Question 5

Amiloride

Answer 5

Block Na Channel in CCT

increase blood K and Acidosis

Question 6

eplereone

Answer 6

competitive aldosterone receptor antagonist in cortical collecting tubule
Hyper aldosteronism, K depletion, CHF
blood: increase K,H, endocrine effect for spironolactone

Question 7

Triamterene

Answer 7

Block Na Channel in CCT

increase blood K and Acidosis

Question 8

acidemia occurs in

Answer 8

1. carbonic anhydrase inhibitor: decrease HCO3 absorption
2. K sparing-aldosterone blockade prevents k secretion and H secretion, hyperkalemia lead to k entering cell with K/H exchange H out of cell

Question 9

alkalemia in diuretics

Answer 9

loop and thiazide

1. volume contraction->AT II increase->Na/H exchange in proximal tubule, increase HCO3-reabsorption
2. K loss leads to K exiting all cells (K/H), H entering cell
3. in low k state, H rather than K, is exchanged for Na in cortical collecting tubule, leading to alkalosis and paradoxical aciduria

Question 10

urine Ca

Answer 10

increase loop diuretics: decrease paracellular Ca reabsorption->hypocalcemia
decrease with thiazide: enhance paracellular Ca reabsorption in proximal tubule and loop of henle

Question 11

Urine K

Answer 11

increase in all except K sparing

Question 12

Mannitol

Answer 12

osmotic dirutics
increase tubular fluid osm
producing increase urine flow
decrease intracranial/intraocular pressure
tox: pulmonary edema, dehydration, CI in anuria, CHF

Question 13

Captopril

Answer 13

*inhibit angiotensin-converting enzyme (ACE)->decrease angiotensin II->decrease GFR by preventing constriction of efferent arterioles
*increase renin as a result of loss feed back inhibition
*ACEI also prevents inactivation of bradykinin, a potent vasodilator
*used in HTN, CHF, proteinuria, diabetic renal disease, prevent remodeling of heart->chronic hypertension.
*Cough,Angioedema,Teratogen,Crea increase,HyperK,Hypotension
avoid in bilateral renal stenosis

Question 14

enlapril

Answer 14

*inhibit angiotensin-converting enzyme (ACE)->decrease angiotensin II->decrease GFR by preventing constriction of efferent arterioles
*increase renin as a result of loss feed back inhibition
*ACEI also prevents inactivation of bradykinin, a potent vasodilator
*used in HTN, CHF, proteinuria, diabetic renal disease, prevent remodeling of heart->chronic hypertension.
*Cough,Angioedema,Teratogen,Crea increase,HyperK,Hypotension
avoid in bilateral renal stenosis

Question 15

lisinopril

Answer 15

*inhibit angiotensin-converting enzyme (ACE)->decrease angiotensin II->decrease GFR by preventing constriction of efferent arterioles
*increase renin as a result of loss feed back inhibition
*ACEI also prevents inactivation of bradykinin, a potent vasodilator
*used in HTN, CHF, proteinuria, diabetic renal disease, prevent remodeling of heart->chronic hypertension.
*Cough,Angioedema,Teratogen,Crea increase,HyperK,Hypotension
avoid in bilateral renal stenosis

Question 16

losartan

all sartan

Answer 16

Angiotensin II receptor blockers have effects similar to ACEI but do not increase bradykinin->no cough or angioedema