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Pharmacology & Drugs > Renal- Diuretics > Flashcards

Renal- Diuretics Flashcards

1
Q

What are the clinical applications for amiloride

A

Counteracts the potassium loss of other diuretics during edema or hypertension

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2
Q

What is the effect of the potassium sparing diuretics on the levels of bicarbonate loss

A

Significant bicarbonate loss by interfering with the distal H+ secretion

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3
Q

At what location do sodium channel blockers work

A

Cortical collecting duct

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4
Q

What class of drug is metolazone

A

Thiazide diuretics

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5
Q

At what location do thiazide diuretics work

A

Distal convoluted tubule

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6
Q

What class of drug is acetazolamide

A

Carbonic anhydrase inhibitor

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7
Q

IN the case of cardiac failure, where digitalis is used, what drugs must also be monitored and what is the reason

A

-Potassium losing diuretics because hypokalemia increases the toxicity of digitalis, so the levels of potassium must be watched

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8
Q

What class of drug is hydrochlorothizide

A

Thiazide diuretics

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9
Q

What are the adverse effects of carbonic anhydrase inhibitors

A

Hyperchloemic metabolic acidosis
Renal stones:nephrolithiasis
Potassium wasting

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10
Q

What class of drug is torsemide

A

Loop diuretic

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11
Q

What is the mechanism of action for eplerenone

A

Blocks aldosterone from being able to bind to its receptor, meaning that more sodium is excreted and more potassium reuptaken

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12
Q

At what location do loop diuretics work

A

Thick ascending loop of Henle

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13
Q

What class of drug is spironolactone

A

Aldosterone blocking, potassium sparing diuretic

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14
Q

What class of drug is furosemide

A

Loop diuretic

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15
Q

What is the class of drug for triamterene

A

Sodium channel blocker, potassium sparing diuretic

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16
Q

What is the condition of the urine with a loop diuretic

A

Isotonic urine

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17
Q

What are the urine effects of giving a loop diuretic

A

-Loss of water, sodium, potassium, chloride, magnesium, and calcium

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18
Q

What is the clinical applications of aldosterone blocker, potassium sparing diuretics

A

Counteracts potassium loss of other diuretics usually used with hypertension and edema.

  • Reduced fibrosis in post-MI heart failure
  • Primary hyperaldosteronism
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19
Q

At what location do osmotic diuretics work

A

Proximal tubule

Thin descending limb of Henle

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20
Q

What is the relation of the loop diuretics with regards to their benefits

A

Torsemide-Longer half life, works better in heart failure
Bumetanide-more predicatable Oral Absorption
Ethacrynic acid- Used in sulfa allergies

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21
Q

How do thiazides decrease the risk of kidney stones

A

Decreases the calcium excretion (as opposed to the loop diuretics) because more is absorbed in the proximal tubules due to volume contraction

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22
Q

What is the result of action potentials during hyperkalemia

A

Depolarizers membranes and increases firing

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23
Q

What is the treatment for nephrogenic diabetes insipidus if the cause is not lithium

A

Thiazides

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24
Q

What are the toxicities assocaited with loop diuretics

A

Low levels of:Mg, Cl, Na, K, Ca

  • Hypochloremic metabolic alkalosis
  • Hyperglycemia
  • Hyperuricemia
  • ototoxicity
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25
Q

What is the mechanism of action in thiazides

A

Blocks the sodium calcium transporter in the distal convoluted tubule

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26
Q

What is the mechanism of action for spironolactone

A

Blocks aldosterone from being able to bind to its receptor, meaning that more sodium is excreted and more potassium reuptaken

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27
Q

What class of drug is chlorthalidone

A

Thiazide diuretics

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28
Q

What must be considered in the use of torsemide

A

Sulfa drug, so watch for allergies

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29
Q

What are the main toxicities of the sodium blocker, potassium sparing diuretics

A
  • Hyperkalemia (main one)
  • Hyponatremia
  • hyper chloremic metabolic acidosis
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30
Q

What is the mechanism of action for Triamterene

A

Blocks the luminal ENaC channels in the collecting ducts, which decreases reuptake of sodium and increases the amount in urine, while decreasing the amount of potassium loss

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31
Q

What are the therapeutic uses

A

-Prophylaxis of renal failure (keeps water in the tubules)-Reduction in intracranial and intraocular pressures

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32
Q

What is the mechanism of action of the thiazides

A

Sodium/Chloride cotransporter blocker in the distal convoluted tubule

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33
Q

What is a major side effect of furosemide with regards to organ systems

A

Causes ototoxicities

34
Q

At what location do the aquaretics known as -Vaptans work

A

Collecting duct

35
Q

What are the effects of hypokalemia on the heart

A
  • Flattened T waves
  • Tall U waves
  • Prolonged QT
36
Q

What is a serious side effect on a different receptor in the use of aldosterone blocker diuretics

A

Partial agonist at androgen receptors

37
Q

What are the clinical applications of using a loop diuretic

A

Edema from CHF
To decrease ECF volume
Hypertension

38
Q

What class of drug is amiloride

A

Sodium channel blocker, potassium sparing diuretic

39
Q

What class of drug is mannitol

A

Osmotic diuretic

40
Q

What class of drug is ethacrynic acid

A

Loop diuretic

41
Q

What is the mechanism of action for the aquaretics known as the -Vamptans

A

Block the ADH receptor in the collecting duct, so there is more water excreted

42
Q

What class of drug is spironolactone

A

Aldosterone antagonist, potassium sparing diuretic

43
Q

What are the toxicities of using aldosterone blocking potassium sparing diuretics

A

Hyperkalemia

-amenorrhea, hirtutism, hynocomastia, impotence, tumorgenic

44
Q

At what location do carbonic anhydrase inhibators work

A

Proximal Tubule

45
Q

How do loop diuretics lead to a loss of magnesium and calcium

A

Potassium is not allowed to leak back in, which normally pulls calcium and magnesium in with it.

46
Q

What are the clinical applications for thiazides

A
  • Hypertension (does not work if there is low GFR)
  • Edema
  • Calcium nephrolithiasis
  • Nephrogenic diabetes insipidus
47
Q

What are the adverse effects of mannitol

A

-ECF is increased because it pulls water our of the cells, with fluid and electrolyte imbalanced

48
Q

What is a main thing hydrochlorothiazide is used to treat

A

Nephrogenic diabetes insipidus

49
Q

What are the effects of using a thiazide

A

Increases the urinary excretion of:

-Water, sodium, potassium, and magnesium

50
Q

What is a diuretic

A

Promotes excretion of urine

51
Q

What must be considered in the use of butetanide

A

Sulfa drug, so watch for allergies

52
Q

What is the mechanism of action for amiloride

A

Blocks the luminal ENaC channels in the collecting ducts, which decreases reuptake of sodium and increases the amount in urine, while decreasing the amount of potassium lost

53
Q

What are the toxicities associated with thiazides

A

Low levels of:K, Mg, Na, Cl
-Hypochloremic metabolic alkalosis
Hyperglycemia, hypercalcemia, hyperuricemia

54
Q

What are the pharmacokinetics of aldosterone blocker potassium sparing diuretics

A

Because not directly blocking receptors, can take 24 hours to take effect

55
Q

What is a aquaretic

A

Substance that produces free water clearance

56
Q

At what location does spironolactone work

A

Cortical collecting duct

57
Q

What are the toxicities of the -Vamptans

A

Orthostatic hypotension
Thirst
Fatal hepatotoxicitiy

58
Q

What is a crucial aspect to loop diuretics with regards to patients with hypertension

A

Given when others have failed because can be used in cases where RBF and GFR are low

59
Q

What class of drug is triamterene

A

Sodium channel blocking potassium sparing diuretic

60
Q

What is the mechanism of action for the conivaptan

A

Non-peptide arginine vasopressin receptor antagonist

61
Q

What is the clinical application of triamterene

A

Counteracts the potassium loss of other diuretics during edema or hypertension

62
Q

What is the treatment for nephrogenic diabetes insipidus if the cause is lithium

A

Amiloride (blocks the influx of lithium into the CCD cells)

63
Q

What is the effect seen if someone ingests too much real licorice

A

Contains glycyrrhizic acid, with can potential aldosterone effects and lead to kidney and increases in systolic blood pressure

64
Q

What must be considered in the use of furosemide

A

A sulfa drug, so watch for allergies

65
Q

What is the result of action potentials in the case of hypokalemia

A

Hyperpolarizes the membranes and decreases firing

66
Q

What are the clinical applications of conivaptan and tolvaptan

A

Treatment of hypervolemia and euvolemia in patients who are hyponatremic (only in those who are in the hospital so they can be closely monitored)
-Can slow progression of adult polycystic kidney disease

67
Q

What is a natriuretic

A

Substance that promotes the renal excretion of sodium

68
Q

What drug interactions must be avoided with the use of aldosterone blocking potassium sparing diuretic

A

Drugs that increase plasma potassium levels or ACE inhibitors

69
Q

What class of drug is conivaptan

A

Auaretics

70
Q

What are the pharmacokinetics of the -vamptans

A

Product of CYP3A4, so must be watched with the inducers or inhibitors of it

71
Q

What is the mechanism of the loop diuretics

A

Sodium/potassium/chloride co transporter blocker in the loop of Henle (ascending thick)

72
Q

What is the mechanism of action for tolvaptan

A

Selective V2 receptor antagonist administered of organs

73
Q

In the cause of a patient with a sulfa allergy, which loop diuretic must be given

A

Ethacrynic acid

74
Q

What is a caution when using hydrochlorothiazide in some patients

A

A sulfa drug, so watch for allergies

75
Q

What class of drug is tolvaptan

A

Aquaretics

76
Q

What class of drug is amiloride

A

Sodium channel blocker, potassium sparing diuretic

77
Q

What is the characteristic of urine while used a thiazide

A

Dilute urine

78
Q

What class of drug is eplerenone

A

Aldosterone antagonist, potassium sparing diuretic

79
Q

What class of drug is bumetanide

A

Loop diuretic

80
Q

What are the effects of Hyperkalemia on the heart

A 
Tall T waves
Prolonged PR
Widened QRS
Flat P
Bradycardia

Pharmacology & Drugs (43 decks)

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