Fa Renal - Pharmacology

Front 1

Site of action of Acetazolamide?

Back 1

proximal convoluted tubule

Front 2

Site of action of Osmotic diuretics (mannitol)? (3)

Back 2

proximal convoluted tubule
loop of Henle
collecting duct

Front 3

Site of action of Loop agents (furosemide)? (2)

Back 3

distal convoluted tubule
thick ascending limb of loop of Henle

Front 4

Site of action of K+ sparing diuretics?

Back 4

distal convoluted tubule

Front 5

Site of action of ADH antagonists?

Back 5

collecting duct

Front 6

MOA of Mannitol?

Back 6

Osmotic diuretic, ↑ tubular fluid osmolarity, producing ↑ urine flow.

Front 7

Clinical use of Mannitol?

Back 7

-shock
-drug overdose
-↓ intracranial/intraocular pressure.

Front 8

Toxicity of Mannitol? (2)

Who is it C/I in?

Back 8

-pulmonary edema
-dehydration

Contraindicated in anuria, CHF.

Front 9

MOA of Acetazolamide?

Where does it act?

Back 9

Carbonic anhydrase inhibitor.

Causes self-limited NaHCO3 diuresis and reduction in total-body HCO3
– stores.

Acts at the proximal convoluted tubule.

Front 10

Clinical use of Acetazolamide? (4)

Back 10

Glaucoma
Urinary alkalinization
Metabolic alkalosis
Altitude sickness

Front 11

Toxicity of Acetazolamide?

Back 11

-hyperchloremic metabolic acidosis
-neuropathy
-NH3 toxicity
-sulfa allergy

Front 12

does acetazolamide cause alkalosis or acidosis?

Back 12

ACIDazolamide causes ACIDosis

Front 13

MOA of Furosemide?

How do you remember what it does to calcium?

Back 13

Sulfonamide loop diuretic.

Inhibits cotransport system (Na+, K+, 2 Cl−) of thick ascending limb
of loop of Henle.

Abolishes hypertonicity of medulla, preventing concentration of urine. ↑ Ca2+ excretion.

"Loops Lose calcium."

Front 14

Clinical use of Furosemide? (3)

Back 14

-Edematous states (CHF, cirrhosis, nephrotic syndrome, pulmonary edema), -hypertension
-hypercalcemia.

Front 15

Toxicity of Furosemide?
-mnemonic?

Back 15

"OH DANG"

Ototoxicity
Hypokalemia
Dehydration
Allergy (sulfa)
Nephritis (interstitial)
Gout

Front 16

MOA of Ethacrynic acid?

Back 16

Phenoxyacetic acid derivative (NOT a sulfonamide).

Essentially same action as furosemide.

Front 17

Clinical use of Ethacrynic acid?

Back 17

Diuresis in patients allergic to sulfa drugs.

Front 18

Toxicity of Ethacrynic acid?

What should it never be used to treat?

Back 18

Similar to furosemide; can be used in hyperuricemia, acute gout (never used to treat gout).

Front 19

MOA of HCTZ?

Back 19

Thiazide diuretic.

Inhibits NaCl reabsorption in early distal tubule, reducing diluting capacity of the nephron.

↓ Ca2+ excretion.

Front 20

Clinical use of HCTZ? (4)

Back 20

Hypertension
CHF
Idiopathic hypercalciuria
Nephrogenic diabetes insipidus

Front 21

Toxicity of HCTZ?
-mneumonic?
-allergy?

Back 21

Hypokalemic metabolic alkalosis
hyponatremia
hyperGlycemia
hyperLipidemia
hyperUricemia
hyperCalcemia

"HyperGLUC"

Sulfa allergy

Front 22

What drugs are K+-sparing diuretics? (4)
-mnemonic?

Back 22

Spironolactone
Triamterene
Amiloride
eplereone

"The K+ STAys"

Front 23

MOA of K+-sparing diuretics?

Back 23

Spironolactone is a competitive aldosterone receptor antagonist in the cortical collecting tubule.

Triamterene and amiloride act at the same part of the tubule by blocking Na+ channels in the CCT.

Front 24

Clinical use of K+-sparing diuretics? (3)

Back 24

Hyperaldosteronism
K+ depletion
CHF

Front 25

Toxicity of K+-sparing diuretics? (2)

Back 25

Hyperkalemia
Endocrine effects (e.g., spironolactone
causes gynecomastia, antiandrogen effects).

Front 26

How does urine NaCl change with diuretics?

Back 26

↑ (all diuretics––carbonic anhydrase inhibitors, loop diuretics, thiazides, K+-sparing diuretics).

Front 27

How does urine K+ change with diuretics?

Back 27

↑ (all except K+-sparing diuretics).

Front 28

How does blood pH change with diuretics?

Back 28

↓ (acidosis)––carbonic anhydrase inhibitors, K+-sparing diuretics

↑ (alkalosis)––loop diuretics, thiazides.

Front 29

How does urine Ca+ change with diuretics?

Back 29

↑ loop diuretics
↓ thiazides

Front 30

What drugs are ACE inhibitors? (3)

Back 30

Captopril
Enalapril
Lisinopril.

Front 31

MOA of ACE inhibitors?

Back 31

Inhibits angiotensin-converting enzyme, reducing levels of angotensin II and preventing inactivation of bradykinin, a potent vasodilator

Renin release is ↑ due to loss of feedback inhibition.

Front 32

Clinical use of ACE inhibitors? (3)

Back 32

Hypertension
CHF
Diabetic renal disease

Front 33

Toxicity of ACE inhibitors?
-mnemonic?

Back 33

"CAPTOPRIL"

Cough
Angioedema
Proteinuria
Taste changes
hypOtension
Pregnancy problems (fetal renal
damage)
Rash
Increased renin
Lower angiotensin II.

Also hyperkalemia.