Renal Drugs

Question 1

Give 3 examples of thiazide diuretics.

Answer 1

Bendroflumethazide
Indapamide
Chortalidone

Question 2

Describe the mechanism of action of thiazide diuretics. (2)

Answer 2

1. Inhibit Na+/Cl- cotransporter in the distal convoluted tubule and collecting duct; therefore inhibits Na+/Cl- reabsorption
2. Therefore increases Na+, Cl- and water excretion

Question 3

List 7 side effects of thiazide diuretics.

Answer 3

Hypokalaemia
Hypomagnesaemia
Hyponatraemia
Hypercalcaemia
Hyperuricaemia
Reduced glucose tolerance
Hypersensitivity

Question 4

List 2 indications for thiazide diuretics.

Answer 4

Hypertension

Oedema

Question 5

Discuss important pharmacokinetics/dynamics of thiazide diuretics. (3)

What would you tell the patient when describing thiazide diuretics? (3)

Answer 5

PHARMACOKINETCS/DYNAMICS:
Diuresis occurs quickly (1-2 hours)
NSAIDs reduce efficacy
Side effects more common with higher doses

PATIENT INFO:
Urinary frequency is NOT affected
Report any sudden rashes
Educate about risks of electrolyte imbalances

Question 6

Give 3 examples of loop diuretics.

Answer 6

Furosemide
Bumetanide
Torasemide

Question 7

Describe the mechanism of action of loop diuretics. (2)

Answer 7

1. Inhibit the Na+/K+/Cl- (NKCC) transporter in the thick ascending loop of Henle
2. This increases excretion of Na+, K+, Cl- and water

Question 8

List 6 side effects of loop diuretics.

Answer 8

Hypokalaemia
Hypovolaemia
Hyperuricaemia
Metabolic acidosis
Abdominal pain
Ototoxicity

Question 9

List 5 indications for loop diuretics.

Answer 9

Hypertension
Hyperkalaemia
Heart failure
Liver cirrhosis
Nephrotic syndrome

Question 10

Discuss important pharmacokinetics/dynamics of loop diuretics. (2)

What would you tell the patient when prescribing loop diuretics? (2)

Answer 10

PHARMACOKINETICS/DYNAMICS:

1. Renal/hepatic excretion - half-life increases in renal/hepatic impairment
2. Therefore dose needs to be adjusted

PATIENT INFO:

1. Urinary frequency will increase
2. Avoid excess alcohol

Question 11

Give 3 examples of insulin preparations.

State whether they are short or long acting.

Answer 11

Novorapid (short acting)

Glargine (long acting)

Humalog mix (mix of long and intermediate acting)

Question 12

Describe the mechanism of action of insulin preparations. (2)

Answer 12

1. Increases cellular uptake of glucose

2. Stimulates glycogenesis, DNA synthesis and growth hormone release

Question 13

List 3 side effects of insulin.

Answer 13

Hypoglycaemia (e.g. tachycardia, headache, sweats)
Oedema
Injection site reactions

Question 14

List 3 indications of insulin.

Answer 14

Type 1 diabetes
Type 2 diabetes
Hyperkalaemia

Question 15

Discuss important pharmacokinetics/ dynamics of insulin. (2)

What would you tell the patient when prescribing insulin? (3)

Answer 15

PHARMACOKINETICS/ DYNAMICS:
Type/regimen of insulin varies
Administration: subcut

PATIENT INFO:
Only take insulin as injections
Compliance is very important
Never skip meals while on insulin

Question 16

Why do you give insulin in hyperkalaemia?

Answer 16

Moves potassium into cells, therefore out of the blood