Renal Drugs Flashcards
1
Q
Tolvaptan (Samsca) misc
A
New drug class with unproven clinical benefit
2
Q
Acetazolamide (Diamox) Class
A
Carbonic anhydrase inhibitors
3
Q
Methazolamide (Neptazane) Class
A
Carbonic anhydrase inhibitors
4
Q
Theophylline (Theolair) Class
A
Bronchodilator (Methylxanthine)
5
Q
Mannitol (Osmitrol) Class
A
Osmotic diuretic
6
Q
Furosemide (Lasix) Class
A
Loop diuretic (- charge)
7
Q
Bumetanide (Bumex) Class
A
Loop diuretic (- charge)
8
Q
Torsemide (Demadex) Class
A
Loop diuretic (- charge)
9
Q
Hydrochlorothiazide (Microzide) Class
A
Thiazide diuretic (- charge)
10
Q
Chlorthalidone (Thalitone) Class
A
Thiazide-like diuretic
11
Q
Indapamide (Lozol) Class
A
Thiazide-like diuretic
12
Q
Amiloride (Midamor) Class
A
K+-sparing diuretic; renal ENaC inhibitor (+ charge)
13
Q
Triamterene (Dyrenium) Class
A
K+-sparing diuretic; renal ENaC inhibitor (+ charge)
14
Q
Spironolactone (Aldactone) Class
A
K+-sparing diuretic; aldosterone receptor antagonist
15
Q
Conivaptan (Vaprisol) Class
A
Aquaretic
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
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
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
19
Q
Mannitol (Osmitrol) MOA
A
Opposes water and sodium reabsorption at proximal tubule –> increased osmolarity of tubular fluid
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
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
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
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
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
25
Metolazone (Zaroxolyn) MOA
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
26
Indapamide (Lozol) MOA
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
27
Amiloride (Midamor) MOA
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
28
Triamterene (Dyrenium) MOA
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
29
Spironolactone (Aldactone) MOA
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
30
Conivaptan (Vaprisol) MOA
Vasopressin (ADH) receptor antagonist working at collecting duct --> increased free water excretion
31
Acetazolamide (Diamox) Therapy
Decrease intraocular volume/pressure and the prevention and treatment of mountain sickness
32
Methazolamide (Neptazane) Therapy
Decrease intraocular volume/pressure and the prevention and treatment of mountain sickness
33
Theophylline (Theolair) Therapy
Reduce inflammation and bronchospasm in moderate to severe asthma, night symptoms; NOT as diuretic
34
Mannitol (Osmitrol) Therapy
Increased clearance of drugs, minimize renal failure (shock or surgery), decrease intraocular or intracranial pressures, diagnose oliguria
35
Furosemide (Lasix) Therapy
Crisis edema (pulmonary, CHF, cirrhosis), hypercalcemia, drug toxicity/OD; severe hypertension in setting of CHF or cirrhosis
36
Bumetanide (Bumex) Therapy
Crisis edema (pulmonary, CHF, cirrhosis), hypercalcemia, drug toxicity/OD; severe hypertension in setting of CHF or cirrhosis
37
Torsemide (Demadex) Therapy
Crisis edema (pulmonary, CHF, cirrhosis), hypercalcemia, drug toxicity/OD; severe hypertension in setting of CHF or cirrhosis
38
Hydrochlorothiazide (Microzide) Therapy
HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus
39
Chlorthalidone (Thalitone) Therapy
Reduce stroke risk, CHF events; HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus
40
Metolazone (Zaroxolyn) Therapy
HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus
41
Indapamide (Lozol) Therapy
HTN (intravascular contraction), chronic edema (cardiac insufficiency), idiopathic hypercalciuria (stones), nephrogenic diabetes insipidus
42
Amiloride (Midamor) Therapy
Combination with other diuretics to prevent hypokalemia; edema, idiopathic hypercalciuria (stones); lithium-induced polyuria & toxicity, Liddle syndrome, mucocilliary clearance
43
Triamterene (Dyrenium) Therapy
Combination with other diuretics to prevent hypokalemia; edema
44
Spironolactone (Aldactone) Therapy
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
Conivaptan (Vaprisol) Therapy
Hyponatremia (SIADH, CHF)
46
Acetazolamide (Diamox) ISE
Increased K+ excretion and metabolic acidosis
47
Methazolamide (Neptazane) ISE
Increased K+ excretion and metabolic acidosis
48
Theophylline (Theolair) ISE
Larger doses give nausea, vomiting, CNS stimulation or seizures, tachycardia/arrythmias
49
Mannitol (Osmitrol) ISE
Risk of pulmonary edema
50
Furosemide (Lasix) ISE
Hypokalemia/hypocalcemia/hypomagnesemia (--> arrhythmia), contraction alkalosis, increased BUN & creatinine, ototoxicity (esp. w/aminoglycoside)
51
Bumetanide (Bumex) ISE
Hypokalemia/hypocalcemia/hypomagnesemia (--> arrhythmia), contraction alkalosis, increased BUN & creatinine, ototoxicity (esp. w/aminoglycoside)
52
Torsemide (Demadex) ISE
Hypokalemia/hypocalcemia/hypomagnesemia (--> arrhythmia), contraction alkalosis, increased BUN & creatinine, ototoxicity (esp. w/aminoglycoside)
53
Hydrochlorothiazide (Microzide) ISE
Hypokalemia/hypercalcemia, contraction alkalosis, increased BUN & creatinine
54
Chlorthalidone (Thalitone) ISE
Hypokalemia/hypercalcemia, contraction alkalosis, increased BUN & creatinine
55
Metolazone (Zaroxolyn) ISE
Hypokalemia/hypercalcemia, contraction alkalosis, increased BUN & creatinine
56
Indapamide (Lozol) ISE
Hypokalemia/hypercalcemia, contraction alkalosis, increased BUN & creatinine
57
Amiloride (Midamor) ISE
Hyperkalemia in patients with renal failure or on ACE inhibitors
58
Triamterene (Dyrenium) ISE
Hyperkalemia in patients with renal failure or on ACE inhibitors
59
Spironolactone (Aldactone) ISE
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
Acetazolamide (Diamox) OSE
Hepatic encephalopathy, BM depression, skin toxicity, allergic reactions
61
Methazolamide (Neptazane) OSE
Hepatic encephalopathy, BM depression, skin toxicity, allergic reactions
62
Furosemide (Lasix) OSE
Hyper -glycemia, -lipidemia, -uricemia; hypo -magnesia, -natremia; gout, photosensitivity, nephrocalcinosis, drug interactions; erectile dysfunction
63
Bumetanide (Bumex) OSE
Hyper -glycemia, -lipidemia, -uricemia; hypo -magnesia, -natremia; gout, photosensitivity, nephrocalcinosis, drug interactions; erectile dysfunction
64
Torsemide (Demadex) OSE
Hyper -glycemia, -lipidemia, -uricemia; hypo -magnesia, -natremia; gout, photosensitivity, nephrocalcinosis, drug interactions; erectile dysfunction
65
Hydrochlorothiazide (Microzide) OSE
Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions
66
Chlorthalidone (Thalitone) OSE
Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions
67
Metolazone (Zaroxolyn) OSE
Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions
68
Indapamide (Lozol) OSE
Hyper -glycemia, -lipidemia, -uricemia, -calcemia; hypo -magnesia, -natremia; gout, photosensitivity, impotence, drug interactions
69
Triamterene (Dyrenium) OSE
Megaloblastic anemia in patients with liver cirrhosis
70
Acetazolamide (Diamox) misc
Contraindicated in cirrhotic patients; FeNa = 5%
71
Methazolamide (Neptazane) misc
Contraindicated in cirrhotic patients; FeNa = 5%
72
Theophylline (Theolair) misc
FeNa = 5%; aminophylline = theophylline + ethyelenediamine (solubility agent); metabolized by liver; cimetidine and quinoline increase blood levels
73
Mannitol (Osmitrol) misc
FeNa = 5%; must give IV; other osmotic diuretics include glucose, urea, isorbide
74
Furosemide (Lasix) misc
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
Bumetanide (Bumex) misc
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
Torsemide (Demadex) misc
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
Hydrochlorothiazide (Microzide) misc
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
Chlorthalidone (Thalitone) misc
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
Metolazone (Zaroxolyn) misc
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
Indapamide (Lozol) misc
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
Amiloride (Midamor) misc
Contraindicated in patients with renal failure (hyperkalemia), ACEi/ARB use; FeNa = 2%
82
Triamterene (Dyrenium) misc
Contraindicated in patients with renal failure (hyperkalemia); FeNa = 2%
83
Spironolactone (Aldactone) misc
Contraindicated in patients with renal failure (hyperkalemia); FeNa = 2%; requires a salt-restricted diet; only drug not requiring tubular lumen access
84
Conivaptan (Vaprisol) misc
New drug class with unproven clinical benefit
85
Carbonic anhydrase inhibitors (2)
1. Acetazolamide (Diamox)
| 2. Methazolamide (Neptazane)
86
Loop Diuretics (3)
1. Furosemide (Lasix)
2. Bumetanide (Bumex)
3. Torsemide (Demadex)
87
Thiazide Diuretics (1)
1. Hydrochlorothiazide (Microzide)
88
Thiazide-Like Diuretics (3)
1. Chlorthalidone (Thalitone)
2. Metolazone (Zaroxolyn)
3. Indapamide (Lozol)
89
Renal Epithelium Na Channel inhibitors (2)
1. Amiloride (Midamor)
| 2. Triamterene (Dyrenium)
90
Aquaretics (1)
1. Conivaptan (Vaprisol)
