Renal

Question 1

Azetazolamide

Answer 1

• Diuretic
• Carbonic anhydrase inhibitor–> prevents conversion of CO2 and H2O to bicarbonate–> no H ions for Na/H antiport–> no lower re-uptake of Na–> loss of water
• Can trigger metabolic acidosis, no longer used as diuretic, treat glaucoma-> decrease aqueous humor

Question 2

Dorzolamide

Answer 2

• Carbonic anhydrase inhibitor, diuretic

- treat alkalosis, altitude sickness

Question 3

Furosemide

Answer 3

• loop diuretic (high ceiling most potent)
• inhibit Na/K/2Cl symport in ascending loop of Henle
• Side effect: loss of K, Ca, Mg
• Other: torasemide, bumetanide

Question 4

Hydrochlorothiazide

Answer 4

• Thiazide diuretic for mild to moderate hypertension and heart failure
• Inhibits Na/Cl symport in the distal convoluted tubule
• loss K, Mg
• Others: benzthiazide, cyclothiazide

Question 5

Spironolactone

Answer 5

• K sparing diuretic, aldosterone receptor antagonist->blocks production of Na/K antiporter in basolateral membrane and Na channels in apical membrane of distal portion of distal tubule
• several day before onset
• Combined with high ceiling diuretics

Question 6

Amiloride

Answer 6

• K sparing diuretic, blocks Na channels in apical membrane of distal portion of distal tubule
• quick onset
• Other: trimterene

Question 7

Mannitol

Answer 7

• Osmotic diuretic, small non-reabsorbable molecule prevents passive water reabsorption
• Also used to treat increased intercranial pressure, cannot cross blood brain barrier-> increased osmolarity draws water into blood
• Used to prevent renal failure
• filtered IV can crystallize

Question 8

Probenicid

Answer 8

• Uricosuric agent used to treat gout and kidney stones, promotes excretion and inhibits reabsorption at high therapeutic dosage
• At low dose inhibits excretion and reabsorption, can cause increase of uric acid in blood
• Also inhibits penicillin excretion
• Other: Sulfinpyrazone