Renal Meds-lecture

Question 1

Where do carbonic anhydrase inhibitors work?

Answer 1

lumen of proximal convoluted tubule

Question 2

What happens when carbonic anhydrase is inhibited?

Answer 2

NaHCO3 (sodium bicarbonate) reabsorption inhibited–>diuresis

Question 3

What does HCO3 depletion result in?

Answer 3

enhanced NaCl reabsorption in the rest of nephron. Limits effectiveness.

Question 4

Indications for Carbonic Anhydrase Inhibitors?

Answer 4

glaucoma, acute altitude sickness, CNS edema

Question 5

MoA of Acetozolamide

Answer 5

reversibly blocks carbonic anhydrase in PCT maintaining NaHCO3 (sodium bicarbonate) in the lumen. Result is diuresis.

Question 6

Side effects of Acetozolamide

Answer 6

Flushing
Ataxia
Electrolyte imbalance
Confusion
Convulsions
SJS
Crystalluria

Question 7

Can someone with a sulfa allergy take Acetozolamide?

Answer 7

no

Question 8

Should someone drink alcohol while on acetozolamide?

Answer 8

no

Question 9

Anti-HTN and acetozolamide interact. What happens?

Answer 9

Acetozolamide increases levels of anti-htn drug

Question 10

Acetozolamide can cause convulsions. Should someone with a seizure disorder/hx of seizures who is on anti-convulsants take this med?

Answer 10

Is that a serious question? Just know that anti-convulsants are dx-dx with acetozolamide.

Question 11

Why do diuretics increase concentrations of other drugs?

Answer 11

Because they make you pee. Same amount of drug in less fluid=higher concentration.

Question 12

HCTZ indications

Answer 12

HTN
Edema in nephrotic syndrome
lithium induced diabetes insipidus

Question 13

How much of NaCl is absorbed prior to distal convoluted tubule?

Answer 13

~90%

Question 14

What does chronic use of HCTZ result in?

Answer 14

decreased Ca excretion

Question 15

eGFR to stop using HCTZ

Answer 15

Loses effectiveness at

Question 16

What is the relationship between HCTZ and gout?

Answer 16

HCTZ increases serum uric acid