Renal pharm

Question 1

Mannitol

Answer 1

Diuretic, increases tubular osmolarity to increase urine flow

site: descending limb

Vs increased intracranial pressure

Toxicity: Pulmonary edema, contraindicated in CHF and anuria

Question 2

Acetazolamide

Answer 2

Carbonic anhydrase inhibitor -> diuresis of NaHCO3

Use: Glaucoma, metaboic alkalosis

Toxicity: Hyperchloremic metabolic acidosis, paresthesia, sulfa allergy

ACIDazolamide causes ACIDosis

Question 3

Furosemide

Answer 3

Loop diuretic -> TAL

Blocks Na+/K+/2l- cotransporter

Decreased concentration of urine, Ca2+ excretion, Increases PGE in afferent arteriole

vs Edema, HTN, can be used in CHF

Toxicity: Ototoxicity, hypokalemia, sulfa allergy, nephritis, GOUT

Question 4

Ethacrynic acid

Answer 4

Loop diuretic

Vs Na+/K+/2 Cl- -> increased PGE release

Used in patients with sulfa allergy

Ototoxic, nephritis, GOUT, hypokalemia

Question 5

Hydrochlorothiazide

Answer 5

Site: Distal tubule

Thiazide diuretic vs NaCl reabsorption, decreased Ca2+ excretion

Use: HTN, CHF, diabetes insipidus

Toxicity: Hypokalemic metabolic alkalosis, hyponatremia, hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia, sulfa

HyperGLUC for toxicity

Question 6

Spironolactone

Answer 6

K+ sparing diuretic -> Collecting tubule

Competitive aldosterone receptor antagonist

Vs CHF, Hyperaldosteronism

Toxicity: Hyperkalemia, gynecomastia

Question 7

Triamterene

Answer 7

K+ sparing diuretic -> collecting tubule

Blocks Na+ channels in cortex

vs CHF, hyperaldosteronism

TOxicity: Hyperkalemia

Question 8

Amiloride

Answer 8

K+ sparing diuretic -> collecting tubule

Blocks Na+ channel in cortex

Toxicity: hyperkalemia

Question 9

Captopril

Answer 9

ACE inhibitors

Vs ACE -> Decreased angiotensin II, decreased GFR by stopped dilation at efferent arteriole. Increased renin, and increased bradykinin (vasodilator)

Vs: HTN, CHF

Toxicity: Cough, teratogen, do not use in bilateral renal artery stenosis, creatinine, hyperkalemia

Question 10

-sartans

Answer 10

ARB

Vs ACE -> Decreased Ang II -> dec constriction of Efferent arteriole

Do not increase bradykinin, no cough!!!