Urinary System Drugs Flashcards
These type of urinary system drugs increase urine volume and frequency by increasing elimination of H2O (in turn, increases urine output)
Diuretics
Two common reasons we would diuresis a patient
- Decrease edema
2. Decrease BP
Extracellular fluid accumulation
edema
Thiazides, Loop, Potassium-sparing, Carbonic annhydrase inhibitors, and osmotics are all classes of
Diuretics
These diuretics work on the DCT of the kidney to manage edema with CHF
Can cause hypokalemia with long term treatment and electrolyte imbalance
Ex: hydrocholothiazide, chlorothiazide, hydroflumethiazide, and bendroflumethiazide
Thiazides
These diuretics are the MOST POTENT and increase the renal excretion of H2O, Na, K, Cl, Mg, H, ammonium, and bicarb
Can cause electrolyte imbalance
Ex: furosemide (Lasix)
Loop Diuretics
If furosemide is given IV, what is the onset of action with functioning kidneys? Oral?
Immediate; 30 minutes
These diuretics are mild act on the DCT to promote Na and water excretion, but retain Potassium
S/E: hyperkalemia
Ex: spironolactone, triamterene, amiloride
Potassium-sparing
This enzyme helps maintain pH balance in the body by regulating H and bicarb ions
Carbonic annhydrase
These diuretics block the action of carbonic annhydrase in the PCT
Mainly used for decreasing ocular pressure with glaucoma
Can cause acidosis and electrolyte imbalance
Ex: acetazolamide, dichlophenamide
CAI’s
carbonic annhydrase inhibitors
These diuretics are quick acting and used for emergencies by increasing the osmolality of the filtrate in the renal tubules
Causes IMMEDIATE diuresis to help prevent renal failure and decrease intraocular pressure
Ex: mannitol, glycerin
Osmotics
High blood pressure is AKA
Hypertension
What can happen if hypertension is left untreated?
Renal and cardiovascular issues
^ BP, ^GFR which = increased kidney workload
Diuretics, ACE inhibitors, Ca-channel blockers, Arteriole vasodilators, Beta Blockers, and Alpha blockers are all examples of
Antihypertensives
How do diuretics act as hypertensives?
They promote Na and water loss and they decrease fluid volume and pressure within vessels
Block the conversion of angiotensin I to angiotensin II
Prevent vasoconstriction and release of aldosterone
Ex: enalapril, captopril, lisinopril, and benazepril
ACE inhibitors
The veterinary approved ACE inhibitor
enalapril
The number one hypertensive category
ACE Inhibitors
These promote myocardial relaxation and lower BP by blocking calcium in the myocardial cells
Affects the GFR by inhibiting contractility of cardiac and vascular smooth muscle
Ex: diltiazem, verapamil, and nifedipine
Ca-Channel Blockers (ccb)
What animals respond best to Ca Channel blockers?
Cats
Cause vasodilation to treat acute hypertension
Ex: nitroprusside, hydralazine, minoxidil
Direct Acting Arteriole Vasodilators
Minoxidil is AKA
Rogaine
Propranalol is a
Beta Blocker
Blocks Alpha-1 receptors to cause vasodilation
Ex: Phenoxybenzamine
Alpha 1 Blockers
You should monitor 3 things with patients on antihypertensives or diuretics
HR, BP, and urine output
AKA stone, calculi
Symptoms include dysuria, hematuria, obstruction
Uroliths
_______ affects pH of urine
Diet
Most common urolith because they are found in urine naturally
struvite (triple phosphate)
Dalmatians and bulldogs are predisposed to what type of uroliths?
Urate
An alkaline urolith
Struvite
A diet used to treat alkaline uroliths
Is it safe to use as a maitenance diet?
S/D
No
Pharmaceuticals used to treat alkaline uroliths
methionine or ammonium chloride
The goal of treating alkaline uroliths is _______ pH
lowering
3 types of acidic urine crystals
- calcium oxalate
- crystine
- ammonium urate
The goal of treating acidic crystals is _________ pH
increasing
Type of diet to use to treat acidic uroliths
Is it safe to use as a maitenance diet?
K/D
Yes
Pharmaceuticals used to treat acidic uroliths
potassium citrate and sodium bicarb
To treat ammonium urate uroliths, an animal should be put on this type of diet to decrease production of uric acid
Low protein, low urea, low oxalate
2 Stages of Incontinence
Neurological and Non neurological
3 types of drugs used to treat neurological incontinence
- Cholinergics
- Anticholinergics
- Adrenergic antagonists
Used to treat animals with spinal cord bladders by promoting voiding of the bladder
Stimulates action of acetylchholine by direct stimulation of cholinergic receptors
Treats retention issues
Ex: benthanechol
Cholinergic
Cholinergics cause the bladder to contract and the urethras to
relax
Treats incontinence by promoting urine retention in the bladder by blocking the binding of acetylcholine to cause muscle relaxation
Ex: proprantheline, dicyclomine, butyl hyoscine
Anticholinergics
Used to decrease tone of the internal urtethral sphincters
Treats decreased urinary tone due to overdistension of the bladder
Alpha antagonists
Two Alpha Blockers
phenoxybenzamine and prazosine
Two things used to treat non neurologic incontinence
Estrogen and Testosterone
Estrogen and Testosterone help increase the
tone of the bladder
A side effect of estrogen
Bone marrow suppression
Non-neurologic incontinence is more common in
spayed females >7 years
These work by increasing the tone of the urethra
Ex: phenylpropanolamine and ephedrine
Adrenergic agonists
Causes hemorrhagic strokes in humans but used in animals to treat stress and hormone incontinence
PPA (phenylpropanolamine)
A xanthine oxidase inhibitor
allopurinol
Trade name for furosemide
Lasix
What drug category does propranolol belong to?
Beta Blockers
What category does spironolactone belong to?
Potassium Sparing Diuretic
A drug used to promote voiding of urine from the bladder
Bethanecole
A drug used to treat urinary incontinence by promoting urine retention
Propantheline
Urine acidifying drug that is used to prevent the formation of struvite uroliths
methionine and ammonium chloride
A urinary alkalizer used to treat calcium oxalate uroliths
Potassium citrate or Sodium bicarbonate
What electrolyte may decrease due to prolonged use of thiazides?
Potassium
What is the onset of action for furosemide when given orally?
30 mins
What is carbonic annhydrase?
Enzyme that helps balance pH
Name 2 carbonic annhydrase inhibitors
- acetazolamide
2. dichlorphenamide
The drug of choice for treating hypertension
enalapril
2 osmotic diuretic used in emergency situations
- glycerin
2. mannitol
4 Thiazides
- Hydrochlorthiazide
- chlorothiazide
- hydroflumethiazide
- bendroflumethiazide
A loop diuretic
Furosemide
3 Potassium sparing diuretics
spirinolactone, amiloride, and triamterene
2 Carbonic annhydrase inhibitors
acetazolamide and dichlorphenamide
2 osmotic diuretics
mannitol and glycerin
4 ACE inhibitors
- enalapril
- captopril
- lisinopril
- benazepril
3 Ca Channel Blockers
- diltiazem
- verapamil
- nifedipine
3 Direct Acting Vasodilators
- hydralazine
- nitropresside
- minoxidil
Beta blocker
propranalol
Alpha blocker
phenoxylbenzamine
Alkaline urolith diets
Hill’s S/D
Alkaline urolith diet (maintenance)
Hills C/D
Hills W/D
Iams Low pH/S
2 pharmaceuticals used to treat alkaline uroliths
- methionine
2. ammonium chloride
3 diets used to treat acidic uroliths
- Hills K/D
- Iams Moderate pH/O
- Purina NF
Urine alkalizer
potassium citrate
2 diets used to treat urate uroliths
- Hills U/D
2. Purina NF
Used to treat urate uroliths
xanthine oxidase inhibitors (allopurinol)
3 types of drugs used to treat neurologic incontinence
- Cholinergics
- anticholinergics
- adrenergic agonists
A cholinergic used to treat neurological incontinence
bethanechol
An anticholinergic used to treat neurological incontinence
propantheline
Alpha adrenergic antagonists used to treat neurological incontinence
phenoxybenamine and prazosine
Adrenergic agonists used to treat non-neurological incontinence
phenylpropanolamine (PPA) and ephedrine
2 hormones used to treat non-neurological incontinence
estrogen and testosterone