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PHARMACOLOGY > Renal Drugs > Flashcards

Renal Drugs Flashcards

1
Q

Mechanism: Mannitol

A

Osmotic diuretic:

Increases tubular fluid osmolarity → increase urine flow, decrease intracranial/intraocular pressure

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2
Q

Clinical use: Mannitol

A

Drug OD

Elevated intracranial/intraocular pressure

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3
Q

Adverse effects: Mannitol

A

Pulmonary edema

Dehydration

Contraindicated: Anuria, HF

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4
Q

Mechanism: Acetazolamide

A

Carbonic anhydrase inhibitor:

Causes self-limited NaHCO3 diuresis and decreases total body HCO3- stores

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5
Q

Clinical use: Acetazolamide

A

Glaucoma

Urinary alkalinization

Metabolic alkalosis

Altitude sickness

Pseudotumor cerebri

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6
Q

Adverse effects: Acetazolamide

A

Proximal renal tubular acidosis

Paresthesias

NH3 toxicity

Sulfa allergy

Hypokalemia

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7
Q

Mechanism: Loop diuretics

Furosemide

Bumetanide

Torsemide

A

Sulfonamide loop diuretic:

Inhibit cotransport system (Na+/K+/2Cl-) of thick ascending limb of loop of henle → abolish hypertonicity of medulla, preventing concentration of urine

Stimulate PGE release (vasodilatory effect on afferent arteriole); inhibited by NSAIDs

Increases Ca2+ excretion

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8
Q

Clinical use: Loop diuretics

Furosemide

Bumetanide

Torsemide

A

Edematous states

Hypertension

Hypercalcemia

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9
Q

Adverse effects: Loop diuretics

Furosemide

Bumetanide

Torsemide

A

Ototoxicity

Hyperkalemia

Pancreatitis

Hypomagnesemia

Dehydration

Allergy (sulfa)

Metabolic alkalosis

Interstitial nephritis

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10
Q

Mechanism: Ethacrynic acid

A

Nonsulfonamide inhibitor of cotransport sytem (Na+/K+/2Cl-) of thick ascending limb of loop of Henle

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11
Q

Clinical use: Ethacrynic acid

A

Diuresis in patients allergic to sulfa drugs

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12
Q

Adverse effects: Ethacrynic acid

A

Similar to fureosemide, but more ototoxic

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13
Q

Mechanism: Thiazide diuretics

Hydrochlorothiazide

Chlorhtalidone

Metolazone

A

Inhibit NaCl reabsorption in early DCT → decreasing diluting capacity of nephron

Decreases calcium excretion

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14
Q

Clinical use: Thiazide diuretics

Hydrochlorothiazide

Chlorhtalidone

Metolazone

A

Hypertension

HF

Idiopathic hypercalciuria

Nephrogenic DI

Osteoporosis

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15
Q

Adverse effects: Thiazide diuretics

Hydrochlorothiazide

Chlorhtalidone

Metolazone

A

Hypokalemic metabolic alkalosis

Hyponatremia

Hyperglycemia

Hyperlipidemia

Hyperuricemia

Hypercalcemia

Sulfa allergy

Pancreatitis

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16
Q

Mechanism: Potassium-sparing diuretics

Spironolacton

Eplerenone

A

Competitive aldosterone receptor antagonists in cortical collecting tubule

17
Q

Mechanism: Potassium-sparing diuretics

Triamterene

Amiloride

A

Inhibit Na+ channels in cortical collecting tubule

18
Q

Clinical use: Potassium-sparing diuretics

Spironolactone

Eplerenone

Triamterene

Amiloride

A

Hyperaldosteronism

K+ depletion

HF

Hepatic ascites (spironolactone)

Nephrogenic DI (amiloride)

Antiandrogen

19
Q

Adverse

20
Q

Adverse effects: Potassium-sparing diuretics

Spironolactone

Eplerenone

Triamterene

Amiloride

A

Hyperkalemia (can lead to arrhythmias)

Spironolactone: Endocrine effects

  • Gynecomastia
  • Antiandrogen effects
21
Q

Mechanism: ACE inhibitors

Captopril

Enalapril

Lisinopril

Ramipril

(-pril)

A

Inhibit ACE → decrease AT II → decrease GFR by preventing constriction of efferent arterioles

Increases renin due to loss of negative feedback

Inhibition of ACE also prevents inactivation of bradykinin, a potent vasodilator

22
Q

Clinical use: ACE inhibitors

Captopril

Enalapril

Lisinopril

Ramipril

(-pril)

A

Hypertension

HF (decreases mortality)

Proteinuria

Diabetic nephropathy

Prevent unfavorable heart remodeling as a result of chronic hypertension

23
Q

Adverse effects: ACE inhibitors

Captopril

Enalapril

Lisinopril

Ramipril

(-pril)

A

Cough

Angioedema (due to increased bradykinin); contraindicated in C1 esterase inhibitor deficiency

Teratogen (fetal renal malformations)

Increased creatinine (decreased GFR)

Hyperkalemia

Hypotension

Use with caution with bilateral renal artery stenosis becasue ACE inhibitors will further decrease GFR → renal failure

24
Q

Clinical use: Angiotensin II receptor blockers

Losartan

Candesartan

Valsartan

A

Hypertension

HF

Proteinuria

Chronic kidney disease (diebetic neuropathy) with intolerance to ACE inhibitors (cough, angioedema)

26
Q

Adverse effects: Angiotensin II receptor blockers

Losartan

Candesartan

Valsartan

A

Hyperkalemia

Decreased GFR

Hypotension

Teratogen

27
Q

Mechanism: Aliskiren

A

Direct renin inhibitor → blocks conversion of angiotensinogen to angiotensin I

28
Q

Clinical use: Aliskiren

A

Hypertension

29
Q

Adverse effects: Aliskiren

A

Hyperkalemia

Decreased GFR

Hypotension

Angioedema

Relatively contraindicated: Patients already taking ACE inhibitors or ARBs

PHARMACOLOGY (33 decks)

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