Renal Drugs

Question 1

4 main drug groups for hypertension treatment

Answer 1

ACE inhibitors
BB
Ca channel blockers
Diuretics (thiazide like)

Question 2

Mechanism of ACEIs

Answer 2

Prevents the formation of angiotensin II leading to vasodilation and decreased bp.
Binds to tissues and plasma proteins so slow elimination by glomerular filtration

Question 3

SE of ACEIs

Answer 3

Hypotension
Dry irritating cough due to accumulation of bradykinin
Hyperkalaemia mediated by reduction of aldosterone

Question 4

MoA of thiazide diuretics?

Answer 4

Acts of the proximal part of the distal convoluted tubule: Increased sodium excretion and urine volume. Leads to reduced blood volume
Decreased peripheral resistance due to subtle alterations in the contractile responses of vascular smooth muscles.

SE: Hypokalaemia

Question 5

MoA Ca channel blockers?

Answer 5

Acts by reducing calcium influx into vascular smooth muscle cells and promoting vasodilation.
Direct action on cardiac and GI muscle cells
3 main groups: Only dihydropyridine used in hypertension

Question 6

MoA beta blockers?

Answer 6

Antagonist the effects of sympathetic system or circulating catecholamine’s at
beta-1 receptors in heart, kidney (inhibits renin release)
beta-2 receptors in lungs, peripheral blood vessels and skeletal muscles

Question 7

Example of loop diuretic?

Answer 7

Furosemide (acts in 1hr at the Loop of henle)

Question 8

Action of furosemide?

Answer 8

Inhibits reabsorption by:
Inhibits the Na+/K+/2Cl- carrier in the luminal membrane
Thereby inhibit the transport of NaCl out of the tubule into the interstitial tissue

Question 9

Uses of furosemide?

Answer 9

Pulmonary oedema due to LVF
Chronic heart failure
Resistant hypertension
Oedema

Question 10

Main thiazide diuretic?

Answer 10

Bendroflumethiazide

Indapamide

Question 11

Action of Bendroflumethiazide and Indapamide?

Answer 11

Thiazide diuretics

At distal tubule

Decrease reabsorption of Na+ and Cl- by binding to the Na+/Cl- co-transport system
Inhibit co-transport’s action
Produces vasodilatation

Question 12

Uses fo thiazide diuretics?

Answer 12

Hypertension
Mild heart failure
Severe resistant oedema

Question 13

2 main K+ sparing diuretics?

Answer 13

Amiloride

Spironolactone

Question 14

Action of amiloride

Answer 14

Blocks Na channels at collection tubule controlled by aldosterone

Question 15

Action of spironolactone

Answer 15

Aldosterone receptor antagonists

Question 16

SE of K+ sparing diuretics?

Answer 16

Hyperkalaemia
GI upset
Metabolic acidosis

Question 17

Spironolactone uses?

Answer 17

HF
Conn’s (primary hyperaldosteronism)
Secondary hyperaldosteronism

Question 18

Osmotic diuretic

Answer 18

Mannitol

Question 19

Oral antibiotics for uti?s

Answer 19

Trimethoprim
Co-amoxiclav
Co-trimoxazole
Ciproflaxacin

Question 20

Topical glucocorticoid?

Answer 20

Beclomethasone

For inflammatory skin conditions e.g. eczema and psoriasis

Question 21

Inhaled glucocorticoid in asthma?

Answer 21

Budesonide

Question 22

Oral/parenteral glucocorticoids?

Answer 22

Hydrocortisone
prednisolone
Dexamethasone

Question 23

Oral/parenteral glucocorticoids, use?

Answer 23

IBS
Asthma
Acute transplant rejection

Question 24

Main mineralocorticoid?

Use?

Answer 24

Fludrocortisone

For mineralocorticoid replacement in adrenocorical insufficiency + Addisions

SE: Hypertension, Na and H2O retention, K+ loss