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47 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Loop Diuretics |
Furosemide, Ethacrynic acid, Butamide, Torsemide |
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Where is the site of action of Loop diuretics? |
The loop of henle |
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What is the mechanism of action for Loop diuretics? |
Decreased sodium potassium 2 chloride co-transporter decreases urine concentration and increases calcium excretion |
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What are the side effects of Loop diuretics? |
-Ototoxicity -hypokalemia -hypocalcemia -dehydration -gout |
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Names 3 Thiazide Diuretics |
*Hydrochlorothiazide *chlorothiazide *chlorthalidone |
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What is the site of action for thiazide diuretics? |
The site of action for thiazide diuretics is the early distal tubule. |
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What is the mechanism of action for thiazide diuretics? |
Decreased sodium chloride reabsorption leading to decreased diluting capacity of the Nephron decreased calcium excretion Therefore increases calcium in body decreased sodium and decreased potassium in body |
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What are the side effects of thiazide diuretics? |
Hypokalemia metabolic alkalosis hyponatremia and Hyper gluc known as hyperGlycemia hyperLipidemia hyperUricemia and hyperCalcemia |
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Why should a patient who has diabetes or gout not receive a thiazide diuretic!? |
Thiazide diuretics increase glucose in the body and increases uric acid |
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What diuretic can be used to increase calcium in the blood of a patient? |
Thiazide diuretics can be used to increase calcium in the body therefore a good option for patients who have osteoporosis |
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Name three potassium sparing agents used as a diuretic |
-Spironolactone -Triamterene -amiloride |
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What is the site of action for potassium sparing agents? |
Cortical collecting tubules |
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What is the mechanism of action for potassium sparing agents? |
Spironolactone is an aldosterone receptor antagonist Triamterene and amiloride are sodium channel blockers. |
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Side effects for potassium sparing agents |
Hyperkalemia gynecomastia sexual dysfunction |
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Carbonic anhydrase inhibitor |
Acetazolamide |
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the site of action for Carbonic anhydrase inhibitors |
Proximal convoluted tubule |
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What is the mechanism of action for acetazolamide? |
Sodium bicarbonate diuresis decreased total body sodium bicarbonate |
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What are the side effects for acetazolamide? |
Hyperchloremic metabolic acidosis nephropathy ammonium toxicity sulfa allergy |
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Name an osmotic agent |
Mannitol |
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Where does Mannitol act on the Nephron? |
Proximal tubules |
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What is the mechanism of action of mannitol? |
Creates increased tubular fluid osmolarity leading to increased urine flow |
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What are the side effects of mannitol? |
Pulmonary edema dehydration contraindicated in anuria and CHF |
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Statins and LDL HDL and TG |
-Statins decrease LDL very much -Statins increase HDL a little -Statins decrease TG a little |
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Niacin and LDL HDL and TG |
Niacin decreases LDL moderately and niacin increases HDL moderately and niacin decreases TG very much |
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Fibrates and LDL HDL and TG |
Fibrates decrease LDL a little fibrates increase HDL moderately and fibrates decrease TG very much |
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Cholesterol inhibitor - ezetimibe
Explain LDL, HDL, and TG |
Ezetimibe decreases LDL moderately increases HDL a little and decreases TG a little |
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Resins LDL HDL TG |
-Resins decrease LDL moderately -resins increase HDL a little and -resins increase TG a little |
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Atorvastatin |
10 - 80 milligrams everyday adult 10 to 20 milligrams per day child |
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Side effects for statins |
Increase CK increased transaminases mild upper GI disturbances myalgia sleep disturbance headache rash peripheral neuropathy Lupus-like symptoms impotence |
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Interactions with atorvastatin |
Macrolide antibiotics Gemfibrizol *grapefruit juice! protease Inhibitors amiodarone cyclosporine
non dihydropyridine: --CCB like Verapamil |
What drink or fruit is contraindicated with a statin? Don't reset tachycardic arrhythmias in the heart with what drug? |
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Don't give atorvastatin in the following conditions |
Acute liver disease alcoholism pregnancy if liver function tests are greater than 3 times normal discontinue the Statins caution in patients with moderate to severe renal impairment less than 60 ml per minute |
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Niacin |
Niacin start with 50 milligrams tid Po
double the dose every 5 days to 1.5 to 2 grams per day if tolerated
maximum of 4 grams per day after meals
Maximum dose goes to 1.5 to 4g per day divided tid po |
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Side effects of niacin |
Hot flashes Pruritus Dry skin Acanthosis nigricans Peptic ulcer reactivation Increase in blood glucose glucose intolerance uric acid and transaminases rare toxicities are Torsade de pointes severe hepatotoxicity
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How can you prevent Flushing in someone taking niacin? |
Uncoated aspirin 325 milligrams daily in the first few weeks or when increasing the dose of niacin. |
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Name a fibrate medication |
Gemfibrozil |
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Gemfibrizol dosage |
300 to 1200 milligrams per day Po 30 minutes prior to meals |
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What are the side effects of gemfibrozil |
Upper GI disturbances myalgias increased Bile lthogenicity increased CK increased creatinine |
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What are common interactions of the fibrates |
Don't use with Statins may increase repaglidinide and rosiglitazone levels Monitor INR when Warfarin is used |
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Cholesterol absorption inhibitor |
Ezetimibe |
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Ezetimibe dosage |
10 milligrams QD PO anytime Must be greater than 12 years old |
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Side effects of ezetimibe |
Back pain Diarrhea abdominal pain fatigue dizziness headache rare side effects are
myopathy Rhabdomyolysis hepatitis acute pancreatitis and thrombocytopenia |
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what drug interacts with a ezetimibe? |
Cyclosporine especially in renal insufficiency |
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Contraindications with ezetimibe? |
Liver problems |
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Name a resin |
Cholestyramine |
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Cholestyramine dosage |
Cholestyramine 4g bid or tid po = adults Children 240 mg/day 80mg tid divided in three doses po |
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Side effects of cholestyramine |
Constipation bloating abdominal fullness flatulence increased TG increased transaminases
rarely: Hyperchloremic acidosis cholecystitis cholelithiasis pancreatitis malabsorption syndrome GI bleeding peptic ulcer |
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Contraindications to cholestyramine |
TG greater than 4.6 millimoles per liter
Biliary obstruction Phenylketonuria Dysbetalipoproteinemia
Long term use or high dose can prevent the absorption of fat-soluble vitamins and folic acid |
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