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Pharm Unit 4 > Renal Drugs > Flashcards

Renal Drugs Flashcards

1
Q

Tolvaptan (Samsca) misc

A

New drug class with unproven clinical benefit

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2
Q

Acetazolamide (Diamox) Class

A

Carbonic anhydrase inhibitors

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3
Q

Methazolamide (Neptazane) Class

A

Carbonic anhydrase inhibitors

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4
Q

Theophylline (Theolair) Class

A

Bronchodilator (Methylxanthine)

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5
Q

Mannitol (Osmitrol) Class

A

Osmotic diuretic

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6
Q

Furosemide (Lasix) Class

A

Loop diuretic (- charge)

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7
Q

Bumetanide (Bumex) Class

A

Loop diuretic (- charge)

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8
Q

Torsemide (Demadex) Class

A

Loop diuretic (- charge)

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9
Q

Hydrochlorothiazide (Microzide) Class

A

Thiazide diuretic (- charge)

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10
Q

Chlorthalidone (Thalitone) Class

A

Thiazide-like diuretic

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11
Q

Indapamide (Lozol) Class

A

Thiazide-like diuretic

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12
Q

Amiloride (Midamor) Class

A

K+-sparing diuretic; renal ENaC inhibitor (+ charge)

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13
Q

Triamterene (Dyrenium) Class

A

K+-sparing diuretic; renal ENaC inhibitor (+ charge)

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14
Q

Spironolactone (Aldactone) Class

A

K+-sparing diuretic; aldosterone receptor antagonist

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15
Q

Conivaptan (Vaprisol) Class

A

Aquaretic

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16
Q

Acetazolamide (Diamox) MOA

A

Inhibits luminal carbonic anhydrase at proximal tubule –> less activity of Na/H antiporter, decreased HCO3 and Na+ (and water) reabsorption

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17
Q

Methazolamide (Neptazane) MOA

A

Inhibits luminal carbonic anhydrase at proximal tubule –> less activity of Na/H antiporter, decreased HCO3 and Na+ (and water) reabsorption

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18
Q

Theophylline (Theolair) MOA

A

Phosphodiesterase inhibition and enhanced signalling via increased cAMP and cGMP; works at proximal tubule; decreased HCO3 and Na+ (and water) reabsorption

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19
Q

Mannitol (Osmitrol) MOA

A

Opposes water and sodium reabsorption at proximal tubule –> increased osmolarity of tubular fluid

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20
Q

Furosemide (Lasix) MOA

A

Inhibits Cl portion of Na-K-2Cl cotransporter in luminal membrane at medullary and cortical (proximal) talH –> decreased K+, Ca++ and Na+ reabsorption, resultant K+ loss

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21
Q

Bumetanide (Bumex) MOA

A

Inhibits Cl portion of Na-K-2Cl cotransporter in luminal membrane at medullary and cortical (proximal) talH –> decreased K+, Ca++ and Na+ reabsorption, resultant K+ loss

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22
Q

Torsemide (Demadex) MOA

A

Inhibits Cl portion of Na-K-2Cl cotransporter in luminal membrane at medullary and cortical (proximal) talH –> decreased K+, Ca++ and Na+ reabsorption, resultant K+ loss

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23
Q

Hydrochlorothiazide (Microzide) MOA

A

Inhibits the Cl portion of the Na-Cl cotransporter in the luminal membrane at the early distal tubule –> decreased Na+ (and water) reabsorption, increased Ca++ reabsorption, resultant K+ loss

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24
Q

Chlorthalidone (Thalitone) MOA

A

Inhibits the Cl portion of the Na-Cl cotransporter in the luminal membrane at the early distal tubule –> decreased Na+ (and water) reabsorption, increased Ca++ reabsorption, resultant K+ loss

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25
Q

Metolazone (Zaroxolyn) MOA

A

Inhibits the Cl portion of the Na-Cl cotransporter in the luminal membrane at the early distal tubule –> decreased Na+ (and water) reabsorption, increased Ca++ reabsorption, resultant K+ loss

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26
Q

Indapamide (Lozol) MOA

A

Inhibits the Cl portion of the Na-Cl cotransporter in the luminal membrane at the early distal tubule –> decreased Na+ (and water) reabsorption, increased Ca++ reabsorption, resultant K+ loss

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27
Q

Amiloride (Midamor) MOA

A

Blocks Na channel and Na/H antiporter in lumenal membrane at the late distal tubule and collecting duct –> decreased K+ secretion and distal tubule acid secretion, increased Ca++ absorption

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28
Q

Triamterene (Dyrenium) MOA

A

Blocks Na channel and Na/H antiporter in lumenal membrane at the late distal tubule and collecting duct –> decreased K+ secretion and distal tubule acid secretion, increased Ca++ absorption

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29
Q

Spironolactone (Aldactone) MOA

A

Competes for aldosterone receptor, inhibiting mRNA transcription and translation –> decreased Na and K channels, decreased number and activity of Na-K-ATPase pumps in the late distal tubule and collecting duct –> decreased K+ secretion, distal tubule acid secretion

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30
Q

Conivaptan (Vaprisol) MOA

A

Vasopressin (ADH) receptor antagonist working at collecting duct –> increased free water excretion

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31
Q

Acetazolamide (Diamox) Therapy

A

Decrease intraocular volume/pressure and the prevention and treatment of mountain sickness

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32
Q

Methazolamide (Neptazane) Therapy

A

Decrease intraocular volume/pressure and the prevention and treatment of mountain sickness

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33
Q

Theophylline (Theolair) Therapy

A

Reduce inflammation and bronchospasm in moderate to severe asthma, night symptoms; NOT as diuretic

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34
Q

Mannitol (Osmitrol) Therapy

A

Increased clearance of drugs, minimize renal failure (shock or surgery), decrease intraocular or intracranial pressures, diagnose oliguria

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35
Q

Furosemide (Lasix) Therapy

A

Crisis edema (pulmonary, CHF, cirrhosis), hypercalcemia, drug toxicity/OD; severe hypertension in setting of CHF or cirrhosis

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36
Q

Bumetanide (Bumex) Therapy

A

Crisis edema (pulmonary, CHF, cirrhosis), hypercalcemia, drug toxicity/OD; severe hypertension in setting of CHF or cirrhosis

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37
Q

Torsemide (Demadex) Therapy

A

Crisis edema (pulmonary, CHF, cirrhosis), hypercalcemia, drug toxicity/OD; severe hypertension in setting of CHF or cirrhosis

38
Q

Hydrochlorothiazide (Microzide) Therapy

A

HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus

39
Q

Chlorthalidone (Thalitone) Therapy

A

Reduce stroke risk, CHF events; HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus

40
Q

Metolazone (Zaroxolyn) Therapy

A

HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus

41
Q

Indapamide (Lozol) Therapy

A

HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus

42
Q

Amiloride (Midamor) Therapy

A

Combination with other diuretics to prevent hypokalemia; edema, idiopathic hypercalciuria (stones); lithium-induced polyuria & toxicity, Liddle syndrome, mucocilliary clearance

43
Q

Triamterene (Dyrenium) Therapy

A

Combination with other diuretics to prevent hypokalemia; edema

44
Q

Spironolactone (Aldactone) Therapy

A

Reduction in CHF mortality (30% in NYHA class III and IV); combination with other diuretics to prevent hypokalemia; edema; primary and secondary aldosteronism; hypertension; anti-testosterone agent

45
Q

Conivaptan (Vaprisol) Therapy

A

Hyponatremia (SIADH, CHF)

46
Q

Acetazolamide (Diamox) ISE

A

Increased K+ excretion and metabolic acidosis

47
Q

Methazolamide (Neptazane) ISE

A

Increased K+ excretion and metabolic acidosis

48
Q

Theophylline (Theolair) ISE

A

Larger doses give nausea, vomiting, CNS stimulation or seizures, tachycardia/arrythmias

49
Q

Mannitol (Osmitrol) ISE

A

Risk of pulmonary edema

50
Q

Furosemide (Lasix) ISE

A

Hypokalemia/hypocalcemia/hypomagnesemia (–> arrhythmia), contraction alkalosis, increased BUN & creatinine, ototoxicity (esp. w/aminoglycoside)

51
Q

Bumetanide (Bumex) ISE

A

Hypokalemia/hypocalcemia/hypomagnesemia (–> arrhythmia), contraction alkalosis, increased BUN & creatinine, ototoxicity (esp. w/aminoglycoside)

52
Q

Torsemide (Demadex) ISE

A

Hypokalemia/hypocalcemia/hypomagnesemia (–> arrhythmia), contraction alkalosis, increased BUN & creatinine, ototoxicity (esp. w/aminoglycoside)

53
Q

Hydrochlorothiazide (Microzide) ISE

A

Hypokalemia/hypercalcemia, contraction alkalosis, increased BUN & creatinine

54
Q

Chlorthalidone (Thalitone) ISE

A

Hypokalemia/hypercalcemia, contraction alkalosis, increased BUN & creatinine

55
Q

Metolazone (Zaroxolyn) ISE

A

Hypokalemia/hypercalcemia, contraction alkalosis, increased BUN & creatinine

56
Q

Indapamide (Lozol) ISE

A

Hypokalemia/hypercalcemia, contraction alkalosis, increased BUN & creatinine

57
Q

Amiloride (Midamor) ISE

A

Hyperkalemia in patients with renal failure or on ACE inhibitors

58
Q

Triamterene (Dyrenium) ISE

A

Hyperkalemia in patients with renal failure or on ACE inhibitors

59
Q

Spironolactone (Aldactone) ISE

A

Hyperkalemia in patients with renal failure or on ACE inhibitors; male patients may have gynecomastia, erectile dysfunction, and loss of libido; female patients may have amenorrhea, breast soreness, and oligomenorrhea

60
Q

Acetazolamide (Diamox) OSE

A

Hepatic encephalopathy, BM depression, skin toxicity, allergic reactions

61
Q

Methazolamide (Neptazane) OSE

A

Hepatic encephalopathy, BM depression, skin toxicity, allergic reactions

62
Q

Furosemide (Lasix) OSE

A

Hyper -glycemia, -lipidemia, -uricemia; hypo -magnesia, -natremia; gout, photosensitivity, nephrocalcinosis, drug interactions; erectile dysfunction

63
Q

Bumetanide (Bumex) OSE

A

Hyper -glycemia, -lipidemia, -uricemia; hypo -magnesia, -natremia; gout, photosensitivity, nephrocalcinosis, drug interactions; erectile dysfunction

64
Q

Torsemide (Demadex) OSE

A

Hyper -glycemia, -lipidemia, -uricemia; hypo -magnesia, -natremia; gout, photosensitivity, nephrocalcinosis, drug interactions; erectile dysfunction

65
Q

Hydrochlorothiazide (Microzide) OSE

A

Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions

66
Q

Chlorthalidone (Thalitone) OSE

A

Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions

67
Q

Metolazone (Zaroxolyn) OSE

A

Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions

68
Q

Indapamide (Lozol) OSE

A

Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions

69
Q

Triamterene (Dyrenium) OSE

A

Megaloblastic anemia in patients with liver cirrhosis

70
Q

Acetazolamide (Diamox) misc

A

Contraindicated in cirrhotic patients; FeNa = 5%

71
Q

Methazolamide (Neptazane) misc

A

Contraindicated in cirrhotic patients; FeNa = 5%

72
Q

Theophylline (Theolair) misc

A

FeNa = 5%; aminophylline = theophylline + ethyelenediamine (solubility agent); metabolized by liver; cimetidine and quinoline increase blood levels

73
Q

Mannitol (Osmitrol) misc

A

FeNa = 5%; must give IV; other osmotic diuretics include glucose, urea, isorbide

74
Q

Furosemide (Lasix) misc

A

FeNa = 25%; eventually causes increase in PT reabsorption,decreases positive & negative free water clearance; decreases cortex-medulla molarity gradient; avoid NSAIDs, take before salty meals, reduce salt intake; useful in patients with renal insufficiency (GFR < 30-40)

75
Q

Bumetanide (Bumex) misc

A

FeNa = 25%; eventually causes increase in PT reabsorption,decreases positive & negative free water clearance; decreases cortex-medulla molarity gradient; avoid NSAIDs, take before salty meals, reduce salt intake; useful in patients with renal insufficiency (GFR < 30-40)

76
Q

Torsemide (Demadex) misc

A

FeNa = 25%; eventually causes increase in PT reabsorption,decreases positive & negative free water clearance; decreases cortex-medulla molarity gradient; avoid NSAIDs, take before salty meals, reduce salt intake; useful in patients with renal insufficiency (GFR < 30-40)

77
Q

Hydrochlorothiazide (Microzide) misc

A

FeNa = 8%; lethal interaction w/quinidine (v. tach –> fib, may be due to hyperkalemia); avoid NSAIDs, bile sequestrants; increased risk of hypokalemia w/anti-inflammatory steroids or Amphotericin B; decreases positive free water clearance

78
Q

Chlorthalidone (Thalitone) misc

A

FeNa = 8%; lethal interaction w/quinidine (v. tach –> fib, may be due to hyperkalemia); avoid NSAIDs, bile sequestrants; increased risk of hypokalemia w/anti-inflammatory steroids or Amphotericin B; decreases positive free water clearance

79
Q

Metolazone (Zaroxolyn) misc

A

FeNa = 8%; lethal interaction w/quinidine (v. tach –> fib, may be due to hyperkalemia); avoid NSAIDs, bile sequestrants; increased risk of hypokalemia w/anti-inflammatory steroids or Amphotericin B; decreases positive free water clearance

80
Q

Indapamide (Lozol) misc

A

FeNa = 8%; lethal interaction w/quinidine (v. tach –> fib, may be due to hyperkalemia); avoid NSAIDs, bile sequestrants; increased risk of hypokalemia w/anti-inflammatory steroids or Amphotericin B; decreases positive free water clearance

81
Q

Amiloride (Midamor) misc

A

Contraindicated in patients with renal failure (hyperkalemia), ACEi/ARB use; FeNa = 2%

82
Q

Triamterene (Dyrenium) misc

A

Contraindicated in patients with renal failure (hyperkalemia); FeNa = 2%

83
Q

Spironolactone (Aldactone) misc

A

Contraindicated in patients with renal failure (hyperkalemia); FeNa = 2%; requires a salt-restricted diet; only drug not requiring tubular lumen access

84
Q

Conivaptan (Vaprisol) misc

A

New drug class with unproven clinical benefit

85
Q

Carbonic anhydrase inhibitors (2)

A
  1. Acetazolamide (Diamox)

2. Methazolamide (Neptazane)

86
Q

Loop Diuretics (3)

A
  1. Furosemide (Lasix)
  2. Bumetanide (Bumex)
  3. Torsemide (Demadex)
87
Q

Thiazide Diuretics (1)

A
  1. Hydrochlorothiazide (Microzide)
88
Q

Thiazide-Like Diuretics (3)

A
  1. Chlorthalidone (Thalitone)
  2. Metolazone (Zaroxolyn)
  3. Indapamide (Lozol)
89
Q

Renal Epithelium Na Channel inhibitors (2)

A
  1. Amiloride (Midamor)

2. Triamterene (Dyrenium)

90
Q

Aquaretics (1)

A
  1. Conivaptan (Vaprisol)

Pharm Unit 4 (7 decks)

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