Renal drugs

Question 1

drugs that act at the proximal tubule

Answer 1

Acetazolamide

Question 2

Drugs that act at the descending loop of henle

Answer 2

Mannitol

Question 3

Drugs that work at the ascending loop of henle

Answer 3

Loop diuretics

Question 4

Drugs that work at the proximal convoluted tubule

Answer 4

thiazides

Question 5

Drugs that work at the early collecting duct

Answer 5

Potassium sparing diurectics

Question 6

Drugs that works at the lat collecting duct

Answer 6

ADH antagonist

Question 7

Acetazolamide MOA

Answer 7

carbonic anhydrase inhibitor

reduces total body HCO3 stores—NaHCO3 diuresis

Question 8

Acetazolamide uses

Answer 8

Glaucoma
urinary alkalinization
metabolic alkalosis
altitude sickness
pseudotumor cerebri

Question 9

Acetazolamise toxicity

Answer 9

hyperchloremic metabolic acidosis
paresthesias
NH3 toxicity
sulfa allergy

Question 10

Mannitol MOA

Answer 10

Osmotic diuretic
increase tubular osmolarity to produce increase urine F
decrease intracranial/intraocular pressure

Question 11

Mannitol uses

Answer 11

Drug overdose

elevated intracranial/intraocular pressure

Question 12

Mannitol toxicity

Answer 12

Pulmonary edema

dehydration

Question 13

Mannitol is contraindicated in

Answer 13

Anuria

CHF

Question 14

List the loop diuretics

Answer 14

furosemide

Ethacrynic acid

Question 15

Furosemide MOA

Answer 15

1. inhibits NAK2CL transport of thick ascending limp of loop abolishing hypertonicity of the medulla
2. Stimulates PGE release cause afferent arteriole VD
3. Increases ca2+ excretion

Question 16

Which drug reduces the VD effect of furosemide and MOO

Answer 16

NSAID inhibits PGE release reducing Furosimide response

Question 17

Furosemide clinical use

Answer 17

EDematous states: CHF, cirrhosis, nephrotic syndrome
and Pul edema
HTN
Hypercalcemia

Question 18

Furosemide toxicity

Answer 18

Ototoxic
Hypokalemia
dehyration
allergy to sulfa
Nephritis--intersitial
Gout
OH DANG!

Question 19

Ethycrynic acid MOA

Answer 19

A phenoxyacetic acid derivative with the same action as furosimide

Question 20

Ethacrynic acid use

Answer 20

For diuresis in Pts with Sulfa allergy

Question 21

ethacrynic acid tocixity

Answer 21

OH DANG + hyperuricemia–contraindicate for gout pts

Question 22

Hydrochlorothiazide MOA

Answer 22

1. inhibits NaCl RAB in early distal tubule

2. decreases ca2+ excretion

Question 23

Hydrochlorothiazide uses

Answer 23

HTN
CHF
ideopathic hypercalciuria
nephrogenic DI

Question 24

Hydrochlorothiazide toxicity

Answer 24

hypokalemia metabolic alkalosis
hyponatremia
hyperglycemia
hyperlipidemia
hyperuricemia
hypercalcemia
sulfa allergy

Question 25

List the potassium sparing diuretic and what portion they work

Answer 25

``` Spironolactone eplerenone triamterene amiloride early collecting duct ```

Question 26

Spironolactone and eplererone MOA

Answer 26

aldosterone receptor antagonist

Question 27

Triamterene and amiloride MOA

Answer 27

block Na+ channels in the CCT

Question 28

Clinical use of the potassium sparing diuretics

Answer 28

Hyperaldosteronism K+ depletion CHF

Question 29

K+ sparing diuretics toxicity

Answer 29

Hyperkalemia--arrhythmias | gynecomastia with spironolactone

Question 30

Which diuretics increase urine Na+ and (decrease serum Na+)

Answer 30

All of them

Question 31

Which diuretics lower serum K+ by increasing urine K+

Answer 31

``` All except K+ sparing: Spironolactone eplerenone Amiloride triamterene ```

Question 32

Which diuretic reduce serum pH (acidemia)

Answer 32

Acetazolamide | K+ sparing (b/c they inhibit both K+ and H+ secretion and also by causing hyperkalemia)

Question 33

How does hyperkalemia cause acidemia

Answer 33

More K= enter cells including cells with the H+/K+ exchanger= H is then secreted into blood for K+ going into cell

Question 34

Which diuretics cause alkalemia

Answer 34

Loop diurectics | Thiazides

Question 35

Which diuretics increase urine ca2+ causing hypocalcemia

Answer 35

loop diuretics

Question 36

which diuretics increase serumca2+

Answer 36

thiazides

Question 37

ACEI MOA

Answer 37

1. prevent constriction of efferent arteriole= decrease GFR 2. prevent inactivation of bradykinin= potent VD 3. increase renin--no moreNB

Question 38

ARB MOA and how to recognize ARBS

Answer 38

Same as ACEI except no effect on the activity of bradykinin---no cough or angioedema SARTANS

Question 39

ACEI/ARB uses

Answer 39

HTN--prevents unfavorable remodeling CHF proteinuria DM renal disease

Question 40

ACEI toxicity

Answer 40

``` Cough Angioedema Teratogen--renal malformation Creatine increase--b/c decreases GFR Hyperkalemia Hypotension ```

Question 41

ACEI is contraindicated in and why

Answer 41

Bilateral renal artery stenosis--will further decrease GFR--renal failure