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Board Review - B - Systems Pharmacology > Renal I > Flashcards

Renal I Flashcards

1
Q

mannitol MOA

A

osmotic diuretic

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2
Q

adverse mannitol

A

pulmonary edema
dehydration

CI in heart failure

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3
Q

mannitol clinical use

A

drug overdose

elevated intracranial/intraocular pressure

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4
Q

acetazolamide MOA

A

carbonic anhydrase inhibitor

decrease total body HCO3 stores

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5
Q

acetazolamide clinical use

A 
glaucoma
urinary alkalinization
metabolic alkalosis
altitude sickness
pseudotumor cerebri - high pressure in skull
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6
Q

acetazolamide adverse

A

hyperchloremic metabolic acidosis
paresthesia
NH3 toxicity
sulfa allergy

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7
Q

furosemide

A

loop diuretic

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8
Q

bemetanide

A

loop diuretic

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9
Q

torsemide

A

loop diuretic

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10
Q

loop diuretic MOA

A

inhibit cotransport Na/K/2Cl thick ascending limb

prevent concentration of urine

stimulate PGE release - vasodilatory effect
-inhibited by NSAIDs

incrased Ca excretion - hypoCa

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11
Q

clinical use loop diuretics

A

edematous state - HF, cirrhosis, nephrotic syndrome, pulmonary edema

HTN

hyperCa

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12
Q

adverse loop diuretics

A 
ototoxicity
hypoK
ehydration
sulfa allergy
nephritis - interstitial
gout
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13
Q

ethacrynic acid

A

non - sulfonamide loop diuretic

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14
Q

clinical use ethacrynic acid

A

sulfa allergy - diuresis tx

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15
Q

chlorthalidone

A

thiazide diuretic

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16
Q

thiazide diuretic MOA

A

inhibit NaCl reabsorption - early DCT
-decreased diluting capacity of nephron

decrease Ca excretion

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17
Q

thiazide clinical use

A 
HTN
heart failure
idiopathic hyperCa
nephrogenic DI
osteoporosis
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18
Q

adverse thiazide

A 
hypoK metabolic alkalosis
hypoNa
hyperglycemia
hyperlipidemia
hyperuricemia
hyperCa

sulfa allergy

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19
Q

spironolactone

A

aldosterone antagonist - K sparing

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20
Q

eplerenone

A

aldosterone antagonist - K sparing

21
Q

triamterene

A

Na channel blocker - K sparing

22
Q

amiloride

A

Na channel blocker - K sparing

23
Q

K sparing MOA

A

aldosterone antagonist in collecting tubule

or as Na channel blocker collecting tubule

24
Q

K sparing clinical use

A

hyperaldosteronism
K depletion
heart failure

25
Q

adverse K sparing

A

hyperK - arrhythmia

endocrine effect - spironolactone - gynecomastia, antiandrogen effects

26
Q

diuretics

A 
acetazolaminde
mannitol
loops
thiazides
K sparing
27
Q

acid base with CAIs

A

acidemia

-decreased bicarb reabsorption

28
Q

acid base with K sparing

A

acidemia
-aldosteorne block - prevent K secretion and H secretion

also - hyperK leads to K entering all cells in exchange for H

29
Q

acid base with loops

A

alkalemia - volume contraction
-increased angiotensin II - more Na/H exchange PCT > more bicarb reabsorption (contraction alkalosis)

K loss - leads to K exiting cells exchange for H entering cell

low K state - H exchanged for Na in cortical collecting tubule

30
Q

acid base with thiazides

A

alkalemia - volume contraction
-increased angiotensin II - more Na/H exchange PCT > more bicarb reabsorption (contraction alkalosis)

K loss - leads to K exiting cells exchange for H entering cell

low K state - H exchanged for Na in cortical collecting tubule

31
Q

urine Ca with loops

A

decreased paracellular Ca reabsorption

increased urine Ca

32
Q

urine Ca with thiazides

A

enhanced Ca reabsorption - DCT

decreased urine Ca

33
Q

urine potassium

A

increased with loops

34
Q

captopril

A

ACE inhibitor

35
Q

ramipril

A

ACE inhibitor

36
Q

ACE inhibitor mechanism

A

inhibit ACE

  • decreased ANG II > decreased GFR
  • decreased constriction efferent arterioles

renin increase - loss of feedback

also prevent inactivation of bradykinin

37
Q

ACE inhibitor clinical use

A

HTN, HF, proteinuria

diabetic nephropathy

prevent unfavorable heart remodeling

38
Q

adverse ACE inhibitor

A 
cough
angioedema - lots of bradykinin
teratogen
creatinine increase
hyperKa
hypotension
39
Q

avoid in B/L renal artery stenosis

A

ACE inhibitor - because will further decrease GFR > renal failure

40
Q

losartan

A

ANG II blocker

41
Q

candesartan

A

ANG II blocker

42
Q

valsartan

A

ANG II blocker

43
Q

ANG II blocker MOA

A

block ANG II binding AT1 receptor

44
Q

clinical use ANG II blocker

A

HTN
HF
proteinuria
diabetic nephropathy

45
Q

adverse ANG II blocker

A

hyperK
decreased renal function
hypotension
teratogen

46
Q

aliskiren

A

direct renin inhibitor

block conversion angiotensinogen to ANG I

47
Q

clincal use aliskiren

48
Q

adverse aliskiren

A

hyperK
decreased renal f unction
hypotension

CI - diabetic taking ACE I or ARBs

Board Review - B - Systems Pharmacology (26 decks)

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