Renal

Question 1

Acts on

Proximal tubule

Carbonic anhydrase inhibitor

Answer 1

Acetazolamide

Question 2

Acts on

Proximal tubule

Osmotic diuretic

Answer 2

Mannitol

Question 3

Acts on

Loop of Henle

Sulfonamide

Answer 3

Furosemide

Question 4

Acts on

Loop of Henle

Not a sulfonamide

Answer 4

Ethacrynic acid

derivative of phenoxyacetic acid

Question 5

Acts on

Early distal tubule

Answer 5

Hydrochlorothiazide

Question 6

Acts on

Cortical collecting tubule

Answer 6

K+ sparring diuretics

Spironolactone, eplerenone

Triamterene, amiloride

Question 7

Acts on

Medullary collecting duct

Answer 7

ADH antagonists

Demeclocycline

Conivaptan, tolvaptan

Useful in diabetes insipidus

Question 8

Increases tubular osmolarity, increases urine flow

Decreases ICP/IOP

Drug OD, elevated ICP/IOP

SE: Pulmonary edema, dehydration

Contra: anuria, CHF

Answer 8

Mannitol

Question 9

NaHCO3 diuresis, decreased HCO3- stores

Glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness, pseudotumor cerebri

SE: hyperchloremic metabolic acidosis, paresthesias, ammonia toxicity, sulfa allergy

Answer 9

Acetazolamide

Question 10

Inhibits Na+/K+/2Cl- cotransporter

(abolished hypertonicity in medulla)

Stimulates PGE release

(afferent arteriole dilation)

Increases Ca2+ excretion

Edematous states, hypertension, hypercalcemia

Answer 10

Furosemide

Question 11

OH DANG

Ototoxicity, hypokalemia, dehydration, allergy (sulfa), nephritis, gout

Answer 11

Furosemide toxicity

Question 12

Inhibits Na+/K+/2Cl- cotransporter

Phenoxyacetic acid derivative

Diuresis in patients allergic to sulfa drugs

Hypokalemia, dehydration, hyperuricemia

Answer 12

Ethacrynic acid

Question 13

Inhibits NaCl reabsorption in distal tubule

Decreases calcium excretion

HTN, CHF, idiopathic hypercalciuria, nephrogenic diabetes insipidus

Hypokalemic metabolic alkalosis, hyponatremia, sulfa allergy, hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia

Answer 13

Hydrochlorothiazide

Question 14

HyperGLUC

Hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia

Answer 14

Hydrochlorothiazide toxicity

Question 15

Competitive aldosterone receptor antagonists

(2)

Hyperaldosteronism, K+ depletion, CHF

SE: hyperkalemia, endocrine effects (gynecomastia, antiandrogen effects)

Answer 15

Spironolactone, eplerenone

Question 16

Blocks Na+ channels in cortical collecting tubule

(2)

Hyperaldosteronism, K+ depletion, CHF

SE: hyperkalemia

Answer 16

Triamterene, amiloride

Question 17

Which diuretics

Increase urinary NaCl

Answer 17

All diuretics

Question 18

Which diuretics

increase urinary K+

Answer 18

All except K+ sparring

(Spironolactone, eplerenone, triamterene, amiloride)

Question 19

Which diuretics

cause decreased blood pH

Answer 19

Acetazolamide, spironolactone, eplerenone

Question 20

Which diuretics

cause increased blood pH

(alkalosis)

Answer 20

Furosemide, ethacrynic acid, hydrochlorothiazide

Question 21

Which diuretics

increase urinary Ca2+

Answer 21

Furosemide, ethacrynic acid

Question 22

Which diuretics

decrease urinary Ca2+

Answer 22

Hydrochlorothiazide

Enhanced Ca2+ reabsorption in proximal tubule and loop of Henle

Question 23

Prevents constriction of efferent arterioles

Increased renin (loss of feedback inhibition)

Prevents inactivation of bradykinin

HTN, CHF, proteinuria, diabetic nephropathy, prevent unfavorable heart remodeling as a result of HTN

Cough, angioedema, teratogenic, creatinine increase, hyperkalemia, hypotension

Contra: renal artery stenosis

Answer 23

ACE inhibitors

Captopril, enalapril, lisinopril

Decreases GFR. If used in renal artery stenosis, will lower GFR further, cause renal failure.

Question 24

Prevents constriction of efferent arterioles

Increased renin (no feedback inhibition)

No increase in bradykinin

No cough, angioedema

Answer 24

Angiotensin II receptor blockers

-sartans