Santos - Kidney pharm

Question 1

Acetazolamide (Diamox)

Answer 1

• CA inhibitors at the PCT
• ALKALINE urine -> metabolic ACIDOSIS
• used limited by acidosis

-used for Glaucoma, acute mountain sickness, Centrencephalic epilepsies

Question 2

Furosemide (lasix) and Ethacrynic acid

Answer 2

• inhibit NKCC2 at the TAL
• DILUTES the urine
• hypomagnesium and hypocalcemia
• use not limited by acidosis
• use for edematous states
• RAPID diuresis
• 2nd line for HTN
• not for ANURIA
• not used w/ NSAIDs bc it induces COX2 expression
• OTOTOXICITY
• reduced clearance w/ LITHIUM
• Hypokalemic metabolic ALKALOSIS
• HYPERURICEMIA - not for GOUT

Question 3

Hydrochlorothiazide (Esidrix)

Answer 3

• inhibit NCC at the DCT
• increase Ca++ reabsorption
• 1st line for HTN
• for edematous states
• help w/ nephrogenic diabetes insipidus
• hypokalemic metabolic ALKALOSIS
• not for DIABETICS or GOUT
• action is reduced by PROBENECID

Question 4

Spironolactone

Answer 4

• K+ sparing diuretic
• antagonize the aldosterone receptor -> prevent ENaC transcription

-can cause GYNECOMASTIA

Question 5

Amiloride, Triamterene

Answer 5

• K+ sparing diuretics
• inhibit the ENaC channel

-triamterene -> can cause Kidney stones

Question 6

K+ sparing diuretics

Answer 6

• do NOT waist K+ at CD
• decrease reabsorption of Na+ -> less K+ secreted
• HYPERKALEMIA and ACIDOSIS
• used for edematous states
• for LIDDLE’S SYNDROME

Question 7

Mannitol (Osmitrol)

Answer 7

• osmotic diuretic
• filtered at glomerulus but NOT reabsorbed
• H2O follows
• for edematous states and UROLOGICAL IRRIGATION before surgery
• more active in PCT and descending loop of Henle