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First Aid > Renal drugs > Flashcards

Renal drugs Flashcards

1
Q

which class of diuretics would be most useful for

acute pulmonary edema (classically seen in HF)

A

loop diuretics

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2
Q

which class of diuretics would be most useful for idiopathic hypercalciuria (–> calcium stones)

A

thiazide to decrease renal ca excretion

not loops (loops loose ca)

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3
Q

which class of diuretics would be most useful for glaucoma?

A

acetazolamide

mannitol

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4
Q

which class of diuretics would be most useful for mild to moderate CHF with expanded ECV

A

loop diuretics

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5
Q

which class of diuretics would be most useful in conjunction with loop or thiazide diuretics to retain K?

A

postassiujm sparing diuretics

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6
Q

which class of diuretics would be most useful for edema associated w/ nephrotic syndrome

A

loop

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7
Q

which class of diuretics would be most useful for increased ICP?

A

mannitol!!!

not for its diuretic action but bc of it acts as osmotic load to draw fluid out of brain interstitium

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8
Q

which class of diuretics would be most useful for mild to mod HTN

A

HCTZ

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9
Q

which class of diuretics would be most useful for​hypercalcemia

A

loop

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10
Q

which class of diuretics would be most useful for attitude sickness

A

acetazolamide

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11
Q

which class of diuretics would be most useful for

hyperaldosteronism

A

spironolactone

eplerenone

both are aldosteron antagonist

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12
Q

pt with HF exacerbation needs diuretics but has a sulfa drug allergy. dam what drug should you use now?

A

loop and thiazides are bot sulfa drugs

EXCEPT

ethacrynic acid (loop)

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13
Q
A
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14
Q

what in the nephron does Mannitol work?

A

PCT and Descending limb, loop of henle

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15
Q

what is mannitols MOA

A

Osmotic diuretic. –> inc tubular fluid osmolarity –> inc urine flow, dec intracranial/intraocular pressure.

combank

it inhibits Na and H20 reabsorption

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16
Q

what can mannitol be used for

A

drug overdose

elevated ICP

Acute angle CLOSURE glaucoma.

also combank

cystic fibrosis, bronchiectasis as dry mannitol which is inhaled drawing fluid into lung.

17
Q

mannitol AE:

CI in?

A

pulmonary edema,

dehydration

CI: in anuria, HF

18
Q

.where does Acetazolamide work and whats its MOA

A

PCT

MOA: Carbonic anhydrase inhibitor

causes self limitied NaHCO3- diuresis and dec total body HCO3- stores.

19
Q

Acetazolamide

clinical indications

A

glaucoma (bc hco3 draws water into eye to form aquamous humor thus if block BICARB formation then no aquaous humor production

altitude sickness****

metabolite alkalosis

pseudotumor cerebri (idiopathic intracranial HTN)

20
Q

name the 4 loop diuretics and which one out of the 4 is NOT a sulfa drug

BFT E

A

bumetanide

Flurosemide

torsemide

Ethacrynic acid (not a sulfa drug)

21
Q

what are the side effects of loops?

OHH DAANG

A

Ototoxicity

Hypokalemia

Hypomagnesemia

Dehydration

Allergy (sulfa)

metabolic Alkalosis

Nephritis (interstitial

Gout

22
Q

Which loop diuretic is most ototoxic?

A

ethacrynic acid.

23
Q

where do loops work in nephron

what there MOA

A

Thick ascending limb

(sulonamide loops):

  • inhibit cotransport system (NA/K/2Cl) of thick ascending limb of LOH.
  • Abolish hypertonicity osmotic gradient) of the medulla thus preventing concentration of urine in thin descending limb
  • stimulate PGE release (vasoDILATORY effect on aff arterioles); inhibited by NSAIDS.
  • inc Ca excretion.
24
Q

name the thiazides

A

hydrochlorothiazide,

chlorthalidone

metolazone

25
Q

what in the nephron do thiazides work and what is their moa

A

(distal convoluted tubule)

Inhibit NaCl reabsorptioin in early DCT –> dec diluting capacity of the nephron.

DEC CALCIUM excretion

INC K excretion,

block Na reabsorption in DCT (nacl cotransporter)

26
Q

thiazide Adverse effects

remember

HyperGLUC

A
  • Hyperglycemia
  • HyperLipidemia
  • hyperUricemia
  • hyperCalcemia

hyponatremia

sulfa allergy

27
Q

name the potassium sparing diuretics

take a SEAT

A

Spironolactone and Eplernone = aldosterone antagnosist

Amiloride and Triamterene (act at same part of tubule by blocking Na channels in the cortical collecting tubule)

28
Q

where do K sparing diuretics work

A

cortical collecting tubules

29
Q

what are the K sparing diuretics used for

A

Hyperaldosteronism

K depletion, HF

ascite (spirnonlactone)

Nephrogenic DI (Amiloride

antiandrogen.

30
Q

AE of K sparing diuretics

A

hyperkalemia (can lead to V-tach, V fib)

endocrine effects w/ sprinonolactone (gynecomastia, antiandrogen effects) in progesterone activity

31
Q

what drug is the direct renin inhibitor, blocks conversion of angiotensinogen to angiotensins I

First Aid (15 decks)

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