Urology Drugs - Werner

Question 1

What are the important drugs and substances that are ACTIVELY secreted in the PCT?

Answer 1

acids - probenicide, sulphinpyrazone

bases

Question 2

What does probenicide compete with in the PCT?

Answer 2

penicillin

Question 3

What does sulphinpyrazone compete with in the PCT?

Answer 3

uric acid

Question 4

What kind of drugs do carnivores have delayed elimination of?

Answer 4

low pKa drugs

Question 5

What chemicals have an effect on mesangial cells?

Answer 5

atrial natriuretic peptide - relax
sympathetic - contract
angiotensin 2 - constrict

Question 6

What do carboanydrase inhibitors do?

Answer 6

increase excretion of bicarbonate with accompanying Na, K, and H2O

Question 7

What are carboanhydrase drugs used to treat?

Answer 7

glaucoma

Question 8

What is an example of carboanhydrase inhibitor?

Answer 8

acetazolamide

Question 9

What is the effect of carboanhydrase on the urine?

Answer 9

mild alkaline urine –> metabolic acidosis

Question 10

What part of the nephron is responsible for the countercurrent system?

Answer 10

loop of Henle

Question 11

What parts of the loop of henle are water permeable?

Answer 11

descending limb

Question 12

What are the most powerful diuretic drugs?

Answer 12

loop diuretics - furosemide, bumetanide, torasemide

Question 13

What is the MOA of loop diuretic drugs?

Answer 13

inhibit Na/K/Cl carrier

Question 14

How does loop diuretic drugs cause metabolic alkalosis?

Answer 14

increased Na in DT –> increased loss of H and K

Question 15

What other molecules does loop diuretics affect?

Answer 15

increased loss of Ca and Mg, decreased loss of uric acid

Question 16

What are the pharmacokinetic aspects of loop diuretics?

Answer 16

readily absorbed from GI, strongly protein bound, metabolized in liver

Question 17

What are the SE of loop diuretics?

Answer 17

hypokalemia (and metabolic alkalosis, hypovolemia, hypotension)

Question 18

What happens in the distal tubule?

Answer 18

active Na/Cl transport (dilution)
excretion of H and K (by Na/K pump)
calcium excretion

Question 19

What are the 2 thiazide diuretics?

Answer 19

chlorothiazide and hydrochlorothiazide

Question 20

What is the MOA of chlorothiazide?

Answer 20

blocks Na/Cl symport in DT

Question 21

What other molecules does thiazide drugs effect?

Answer 21

K loss, excretion of uric acid and Ca decreased, excretion of Mg increased

Question 22

What are the extra-renal effects of thiazide drugs?

Answer 22

vasodilation, hyperglycemia, reduce bone loss

Question 23

What happens when thiazide drugs are used in hypertensive states?

Answer 23

initial fall in BP = increase in urine volume

later phase = direct action on BV

Question 24

What are the clinical uses for thiazide diuretics?

Answer 24

hypertension, mild HF, central or nephrogenic diabetes insipidus

Question 25

What are the renal SE of thiazides?

Answer 25

hypokalemia, metabolic alkalosis, increased uric acid in plasma

Question 26

What are the non renal SE of thiazides?

Answer 26

hyperglycemia, increased plasma cholesterol, male impotence, hypersensitivity rxns

Question 27

What do thiazide diuretics compete with to be excreted in the kidney?

Answer 27

uric acid

Question 28

What do the principal cells reabsorb in the CD? What do they secrete?

Answer 28

Absorb: Na Secrete: K

Question 29

What do the intercalated cells do in the CD?

Answer 29

secrete H

Question 30

What influences Na/Cl absorption in the CD?

Answer 30

aldosterone

Question 31

What influences water reabsorption in the CD?

Answer 31

ADH/vasopressin

Question 32

What is the quick effect of aldosterone on the CD?

Answer 32

stimulation of Na/H exchanger (membrane receptors)

Question 33

What is the delayed effect of aldosterone on the CD?

Answer 33

cell receptors -->proteins that activate sodium channels

Question 34

What drugs block the delayed effect of aldosterone in the CD?

Answer 34

amiloride and triamterene

Question 35

What diuretic is a aldosterone receptor antagonist?

Answer 35

spironolactone

Question 36

What increases the diuretic effect of K sparing diuretics?

Answer 36

high sodium load or aldosterone is high

Question 37

What are the 2 clinical uses of K sparing diuretics?

Answer 37

increase K secondary to CHF | edema and ascites

Question 38

What is the active metabolite of spironolactone?

Answer 38

canrenone - long half life

Question 39

What are the SE of spironolactone?

Answer 39

GI, hyperkalemia, gynaecomastia, menstral, testicular, peptic ulcers

Question 40

Which is more poorly absorbed? triamterene or amiloride?

Answer 40

amiloride

Question 41

What do PGE2 and PGI2 influence on hemodynamics?

Answer 41

vasodilation in response to AG2 and norepinephrine mediated vasoconstriction

Question 42

What influence does PGE2 and PGI2 have on renal control of NaCl and water?

Answer 42

increase renal blood flow and natriuresis(excretion of sodium)

Question 43

What are the clinical indications of osmotic diuretics?

Answer 43

intracranial and intraocular pressure | prevention of acute renal failure

Question 44

What are the side effects of osmotic diuretics?

Answer 44

transient expansion of ECF

Question 45

What receptor does telmisartan bind to?

Answer 45

AT1 receptors

Question 46

What kind of molecule is telmisartan?

Answer 46

lipophilic weak acid, binds reversibly

Question 47

What drug can treat benign prostatic hyperplasia?

Answer 47

finasteride

Question 48

What types of drugs should be used for acute prostatitis?

Answer 48

``` basic drugs (erythro, trimetho) lipophilic drugs (flouro, chloram, TMPS) ```

Question 49

What types of antibiotics should be used for cystitis?

Answer 49

small spectrum, cidal

Question 50

What drugs have a effect on the bladder for incontinence?

Answer 50

parasympathicolytics, sympathomimetics

Question 51

What types of drugs will have effects on the spincter of the bladder for incontinence?

Answer 51

smpathomimetics, oestrogens

Question 52

What can treat urethral hypertonicity?

Answer 52

phenoxybenzamine, prazosine, diazepam, dantrolene

Question 53

What is another name for urethral hypertonicity?

Answer 53

detrussor-urethral dyssynergia