Renal-Endo Medications Flashcards
Sulfonylureas
stimulate insulin production, secretion (pancreas); insulin sensitizing
(use for DM2 pts)
Thiazide type diuretic
(HCTZ), treat HTN, could induce or worsen hypokalemia (K+ wasting and Ca2+ wasting), blocks NCC in DCT
Levothyroxin
T4 analogue, treat hypothyroidism
Aliskiren
block enzymatic activity of renin; can help preserve GFR in kidney and treat HTN in an otherwise healthy person
Amiloride
competitive inhibitor of ENaC, decreases driving force of K+ secretion; may be indicatd in HTN pt with hypokalemia (K+ sparing)
Biguanides
(metformin)
inhibits liver gluconeogenesis, enhances insulin receptor signaling
Eplerenone and sprinolactone
mineralcorticoid receptor antagonist; K+ sparing, use to treat resistant HTN
Thiazolidenediones (pioglitazone)
insulin sensitizing agent; enhance action of insulin in target cells
Tolvaptan
V2 receptor antagonist (treat SIADH)
What are insulin sensitizing agents?
thiazolidenedione; sulfonylureas; metformin, insulin
What is indicated in treating classic CAH?
dexomethasone, prednisone, fludrocortisone
Clomiphene
SERM; antagonizes hypothalamic-pituitary ERalpha; can stimulate or inhibit GnRH depending on dose
Luprolide
GnRH agonist; can stimulate or inhibit GnRH depending on dose
dexomethasone, prednisone
glucocorticoid analogues; fold-higher potency than native glucocorticoids
fludrocotisone
mineralcorticoid agonist; treating classic CAH
Bromocryptine
dopamine receptor agonist; block PRL; antagonoize GH secretion = can be used to treat acromegaly
Cabergoline
dopamine receptor agonist; blocks PRL secretion; can treat =galactorrhea and loss of libido in healthy men
Octreotide
somatostatin analogue; impairs GH secretion; can be used to treat acromegaly
enalapril, lisinopril, captopril
ACE inhibitors
Mechanism: impede the production of angiotensin II. Angiotensin II is a vasoconstrictor and
stimulates the secretion of aldosterone.
the “-sartans”: losartan, irbesartan
Angiotensin receptor blockers (ARBs);Mechanism: same rationale as for ACE inhibitors, except these compounds selectively block the
type AT1 angiotensin II receptor
the “-olols”: metoprolol, atenolol, etc..
Beta-blockers: Mechanism: impede the 1-mediated SNS effects; Beta blockers have varying degrees of specificity
for Beta1 over Beta2. In medical practice, the term “Beta blocker” implies blockade of type Beta1 receptors.
amlodipine
Type L Ca2+ channel antagonist:
Mechanism: preferentially blocks type L Ca2+ channels expressed within vascular smooth
muscle; these channels mediate vascular smooth muscle contraction
furosemide
Loop diuretic Mechanism: impairs Na+ , K+ , and Cl- reabsorption by the kidneys. This holds H2O in forming urine and thus induces diuresis.
Calcium channel blockers
verapamil and diltiazem
Mechanism: block cardiac type L Ca2+ channels–delays AV nodal conduction, negative
inotropy; little effect on non-cardiac type L channels.
What medications can slow the progression of diabetic nephropathies and reduce the proteinurea sequelae?
ARBs, ACEIs, renin inhibitors (and/or mineralocorticoid inhibitors)
