Renal-Endo Medications

Question 1

Sulfonylureas

Answer 1

stimulate insulin production, secretion (pancreas); insulin sensitizing
(use for DM2 pts)

Question 2

Thiazide type diuretic

Answer 2

(HCTZ), treat HTN, could induce or worsen hypokalemia (K+ wasting and Ca2+ wasting), blocks NCC in DCT

Question 3

Levothyroxin

Answer 3

T4 analogue, treat hypothyroidism

Question 4

Aliskiren

Answer 4

block enzymatic activity of renin; can help preserve GFR in kidney and treat HTN in an otherwise healthy person

Question 5

Amiloride

Answer 5

competitive inhibitor of ENaC, decreases driving force of K+ secretion; may be indicatd in HTN pt with hypokalemia (K+ sparing)

Question 6

Biguanides

Answer 6

(metformin)

inhibits liver gluconeogenesis, enhances insulin receptor signaling

Question 7

Eplerenone and sprinolactone

Answer 7

mineralcorticoid receptor antagonist; K+ sparing, use to treat resistant HTN

Question 8

Thiazolidenediones (pioglitazone)

Answer 8

insulin sensitizing agent; enhance action of insulin in target cells

Question 9

Tolvaptan

Answer 9

V2 receptor antagonist (treat SIADH)

Question 10

What are insulin sensitizing agents?

Answer 10

thiazolidenedione; sulfonylureas; metformin, insulin

Question 11

What is indicated in treating classic CAH?

Answer 11

dexomethasone, prednisone, fludrocortisone

Question 12

Clomiphene

Answer 12

SERM; antagonizes hypothalamic-pituitary ERalpha; can stimulate or inhibit GnRH depending on dose

Question 13

Luprolide

Answer 13

GnRH agonist; can stimulate or inhibit GnRH depending on dose

Question 14

dexomethasone, prednisone

Answer 14

glucocorticoid analogues; fold-higher potency than native glucocorticoids

Question 15

fludrocotisone

Answer 15

mineralcorticoid agonist; treating classic CAH

Question 16

Bromocryptine

Answer 16

dopamine receptor agonist; block PRL; antagonoize GH secretion = can be used to treat acromegaly

Question 17

Cabergoline

Answer 17

dopamine receptor agonist; blocks PRL secretion; can treat =galactorrhea and loss of libido in healthy men

Question 18

Octreotide

Answer 18

somatostatin analogue; impairs GH secretion; can be used to treat acromegaly

Question 19

enalapril, lisinopril, captopril

Answer 19

ACE inhibitors
Mechanism: impede the production of angiotensin II. Angiotensin II is a vasoconstrictor and
stimulates the secretion of aldosterone.

Question 20

the “-sartans”: losartan, irbesartan

Answer 20

Angiotensin receptor blockers (ARBs);Mechanism: same rationale as for ACE inhibitors, except these compounds selectively block the
type AT1 angiotensin II receptor

Question 21

the “-olols”: metoprolol, atenolol, etc..

Answer 21

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.

Question 22

amlodipine

Answer 22

Type L Ca2+ channel antagonist:
Mechanism: preferentially blocks type L Ca2+ channels expressed within vascular smooth
muscle; these channels mediate vascular smooth muscle contraction

Question 23

furosemide

Answer 23

Loop diuretic
Mechanism: impairs Na+
, K+
, and Cl-
 reabsorption by the kidneys. This holds H2O in forming 
urine and thus induces diuresis.

Question 24

Calcium channel blockers

Answer 24

verapamil and diltiazem
Mechanism: block cardiac type L Ca2+ channels–delays AV nodal conduction, negative
inotropy; little effect on non-cardiac type L channels.

Question 25

What medications can slow the progression of diabetic nephropathies and reduce the proteinurea sequelae?

Answer 25

ARBs, ACEIs, renin inhibitors (and/or mineralocorticoid inhibitors)