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Pharmacology > Renal drugs > Flashcards

Renal drugs Flashcards

1
Q

drugs that act at the proximal tubule

A

Acetazolamide

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2
Q

Drugs that act at the descending loop of henle

A

Mannitol

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3
Q

Drugs that work at the ascending loop of henle

A

Loop diuretics

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4
Q

Drugs that work at the proximal convoluted tubule

A

thiazides

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5
Q

Drugs that work at the early collecting duct

A

Potassium sparing diurectics

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6
Q

Drugs that works at the lat collecting duct

A

ADH antagonist

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7
Q

Acetazolamide MOA

A

carbonic anhydrase inhibitor

reduces total body HCO3 stores—NaHCO3 diuresis

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8
Q

Acetazolamide uses

A 
Glaucoma
urinary alkalinization
metabolic alkalosis
altitude sickness
pseudotumor cerebri
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9
Q

Acetazolamise toxicity

A

hyperchloremic metabolic acidosis
paresthesias
NH3 toxicity
sulfa allergy

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10
Q

Mannitol MOA

A

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

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11
Q

Mannitol uses

A

Drug overdose

elevated intracranial/intraocular pressure

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12
Q

Mannitol toxicity

A

Pulmonary edema

dehydration

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13
Q

Mannitol is contraindicated in

A

Anuria

CHF

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14
Q

List the loop diuretics

A

furosemide

Ethacrynic acid

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15
Q

Furosemide MOA

A
  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
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16
Q

Which drug reduces the VD effect of furosemide and MOO

A

NSAID inhibits PGE release reducing Furosimide response

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17
Q

Furosemide clinical use

A

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

18
Q

Furosemide toxicity

A 
Ototoxic
Hypokalemia
dehyration
allergy to sulfa
Nephritis--intersitial
Gout
OH DANG!
19
Q

Ethycrynic acid MOA

A

A phenoxyacetic acid derivative with the same action as furosimide

20
Q

Ethacrynic acid use

A

For diuresis in Pts with Sulfa allergy

21
Q

ethacrynic acid tocixity

A

OH DANG + hyperuricemia–contraindicate for gout pts

22
Q

Hydrochlorothiazide MOA

A
  1. inhibits NaCl RAB in early distal tubule

2. decreases ca2+ excretion

23
Q

Hydrochlorothiazide uses

A

HTN
CHF
ideopathic hypercalciuria
nephrogenic DI

24
Q

Hydrochlorothiazide toxicity

A 
hypokalemia metabolic alkalosis
hyponatremia
hyperglycemia
hyperlipidemia
hyperuricemia
hypercalcemia
sulfa allergy
25
Q

List the potassium sparing diuretic and what portion they work

A 
Spironolactone
eplerenone
triamterene
amiloride
early collecting duct
26
Q

Spironolactone and eplererone MOA

A

aldosterone receptor antagonist

27
Q

Triamterene and amiloride MOA

A

block Na+ channels in the CCT

28
Q

Clinical use of the potassium sparing diuretics

A

Hyperaldosteronism
K+ depletion
CHF

29
Q

K+ sparing diuretics toxicity

A

Hyperkalemia–arrhythmias

gynecomastia with spironolactone

30
Q

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

A

All of them

31
Q

Which diuretics lower serum K+ by increasing urine K+

A 
All except K+ sparing:
Spironolactone
eplerenone
Amiloride
triamterene
32
Q

Which diuretic reduce serum pH (acidemia)

A

Acetazolamide

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

33
Q

How does hyperkalemia cause acidemia

A

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

34
Q

Which diuretics cause alkalemia

A

Loop diurectics

Thiazides

35
Q

Which diuretics increase urine ca2+ causing hypocalcemia

A

loop diuretics

36
Q

which diuretics increase serumca2+

A

thiazides

37
Q

ACEI MOA

A
  1. prevent constriction of efferent arteriole= decrease GFR
  2. prevent inactivation of bradykinin= potent VD
  3. increase renin–no moreNB
38
Q

ARB MOA and how to recognize ARBS

A

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

39
Q

ACEI/ARB uses

A

HTN–prevents unfavorable remodeling
CHF
proteinuria
DM renal disease

40
Q

ACEI toxicity

A 
Cough
Angioedema
Teratogen--renal malformation
Creatine increase--b/c decreases GFR
Hyperkalemia
Hypotension
41
Q

ACEI is contraindicated in and why

A

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

Pharmacology (13 decks)

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