Ipapburke Pharm Test 2- Diuretic Agents

Front 1

WHAT IS THE GENERIC ACTION OF DIURETICS?

Back 1

ALTER KIDNEY FUNCTION TO INCREASE THE URINE VOLUME

Front 2

THIS CLASS OF DRUGS ALTERS KIDNEY FUNCTION TO INCREASE THE URINE VOLUME

Back 2

DIURETICS

Front 3

WHAT ARE THE FOUR GENERAL METHODS OF ACTION FOR DIURETICS?

Back 3

ION TRANSPORT INHIBITORS, OSMOTIC AGENTS THAT PREVENT WATER REABSORPTION, ENZYME INHIBITORS, AND HORMONE INHIBITION

Front 4

WHAT DO ION TRANSPORT INHIBITORS DO?

Back 4

DECREASE THE REABSORPTION OF SODIUM

Front 5

WHAT SUBTYPES OF DIURETICS ARE TRANSPORT INHIBITORS?

Back 5

LOOPS AND THIAZIDES

Front 6

WHAT DO OSMOTIC AGENTS (DIURETICS) DO?

Back 6

PREVENT WATER REABSORPTION

Front 7

MANNITOL IS WHAT TYPE OF AGENT

Back 7

OSMOTIC DIURETIC

Front 8

GENERAL METHOD OF ACTION OF SPIRONOLACTONE

Back 8

HORMONE INHIBITING DIURETIC (IT IS AN ALDOSTERONE ANTAGONIST)

Front 9

WHERE DO LOOP DIURETICS WORK?

Back 9

ASCENDING LOOP OF HENLE

Front 10

WHERE DO OSMOTIC AGENTS WORK?

Back 10

THROUGHOUT THE KIDNEY

Front 11

WHERE DOES ACETAZOLAMIDE WORK?

Back 11

PCT

Front 12

WHAT IS THE ONLY DIURETIC AGENT THAT WORKS PREDOMINATELY IN THE PROXIMAL TUBULE?

Back 12

CARBONIC ANHYDRASE INHIBITOR

Front 13

HOW DOES A CARBONIC ANHYDRASE INHIBITOR WORK?

Back 13

INHIBITS CARBONIC ANHYDRASE FROM CONVERTING CO2 AND WATER TO BICARBONATE. THUS SODIUM BICARBONATE REABSORPTION IS BLOCKED

Front 14

WHAT IS THE CLINICAL USE FOR ANHYDRASE INHIBITOR?

Back 14

TOO WEAK TO USE FOR CHF OR HTN; USE FOR GLAUCOMA, MOUNTAIN SICKNESS, URINARY ALKALIZATION

Front 15

HOW DOES CARBONIC ANHYDRASE INHIBITOR WORK IN GLAUCOMA PATIENTS?

Back 15

REDUCES AQUEOUS HUMOR OUTFLOW BY BLOCKING CA IN CILIARY BODY WHICH SECRETES HCO3 INTO AQUEOUS HUMOR

Front 16

FORM OF CA INHIBITOR USED FOR GLAUCOMA (NAME DRUG)

Back 16

DORZALAMIDE (TRUSOPT)- OPHTHALMIC CARBONIC ANHYDRASE INHIBITOR

Front 17

WHAT IS THE USE OF DORZOLAMIDE OR TRUSOPT?

Back 17

IT IS AN OPHTHALMIC CA INHIBITOR USED IN THE EYE TO TREAT GLAUCOMA BY REDUCING AQUEOUS HUMOR PRODUCTION

Front 18

IF YOU USED CA INHIBITOR SYSTEMICALLY, WHAT WOULD BE THE SIDE EFFECT?

Back 18

THE BODY WOULD BECOME OVERALL ACIDOTIC, BUT THE URINE WOULD BE ALKALOTIC

Front 19

WHAT TYPE OF AGENT IS DIAMOX (ACETAZOLAMIDE)?

Back 19

CA INHIBITING DIURETIC

Front 20

HOW DO CA INHIBITORS TREAT MOUNTAIN SICKNESS?

Back 20

DECREASE THE AMOUNT AND PH OF CSF WHERE CA IS RESPONSIBLE FOR SECRETING BICARBONATE

Front 21

WHY WOULD YOU USE CARBONIC ANHYDRASE INHIBITOR FOR URINARY ALKALINIZATION?

Back 21

BECAUSE IT INCREASES EXCRETION OF WEAK ACIDS/ DECREASES THE EXCRETION OF WEAK BASES

Front 22

WHAT ARE THE THREE CLINICAL USES FOR CARBONIC ANHYDRASE INHIBITOR?

Back 22

MOUNTAIN SICKNESS, GLAUCOMA, AND URINARY ALKALINIZATION

Front 23

WHAT DIURETICS ACT MOSTLY IN THE DESCENDING LOOP OF HENLE?

Back 23

NO DIURETICS HAVE MAJOR ACTION HERE

Front 24

THE CELLS IN THE ASCENDING LOOP OF HENLE ARE ___________ TO WATER.

Back 24

IMPERMEABLE

Front 25

ACTIVE REABSORPTION OF THESE ELECTROLYTES OCCURS IN THE ASCENDING LOOP OF HENLE

Back 25

SODIUM, POTASSIUM, CHLORIDE IONS

Front 26

WHAT IS THE SITE OF ACTION FOR LOOP DIURETICS?

Back 26

THE ASCENDING LOOP OF HENLE

Front 27

HOW DO LOOP DIURETICS IN THE ASCENDING LOOP OF HENLE CAUSE DIURESIS?

Back 27

LOOP DIURETICS BLOCK NACL AND POTASSIUM REABSORPTION RESULTING IN MORE SODIUM IN THE URINE AND THUS MORE WATER IN THE URINE; ALSO CAUSE THE LOSS OF CALCIUM AND MAGNESIUM

Front 28

WHY ARE LOOP DIURETICS LESS BENEFICIAL TO LITTLE OLD LADIES WITH OSTEOPOROSIS THAN THIAZIDE DIURETICS?

Back 28

BECAUSE LOOP DIURETICS CAUSE LOSS OF CALCIUM IN THE URINE WHEREAS THIAZIDE DIURETICS INCREASE THE AMOUNT OF CA THAT IS REABSORBED IN THE BODY

Front 29

MOST COMMON LOOP DIURETICS

Back 29

FUROSEMIDE (LASIX); BUMETANIDE (BUMEX); TORSEMIDE (DEMADEX)

Front 30

THE THREE MOST COMMON LOOP DIURETICS ALL CONTAIN WHAT

Back 30

SULFA

Front 31

WHAT LOOP DIURETIC CAN BE PRESCRIBED TO SOMEONE WITH A SULFA ALLERGY?

Back 31

ETHACRYNIC ACIC (EDECRIN)

Front 32

WHAT IS THE MECHANISM OF ACTION OF LASIX (FUROSEMIDE)?

Back 32

INHIBIT NA, K, AND CL REABSORPTION IN THE ASCENDING LOOP OF HENLE (INCREASES URINE OUTPUT)

Front 33

LOOP DIURETICS ARRIVE AT THE SITE OF ACTION USING THE _________________ SYSTEM

Back 33

ORGANIC ACID SECRETORY

Front 34

CLINICAL USES FOR LOOP DIURETICS

Back 34

PULMONARY EDEMA, CHF, HYPERTENSION, HYPERCALCEMIA

Front 35

LOOP DIURETICS CAN BE USED IN PATIENTS WITH POOR RENAL FUNCTION. T OR F

Back 35

TRUE

Front 36

THIS TYPE OF DRUG CAN LEAD TO HYPOKALEMIA AND HYPOMAGNESEMIA

Back 36

LOOP DIURETICS

Front 37

WHY DO LOOP DIURETICS CAUSE HYPERURICEMIA?

Back 37

THEY COMPETE WITH URIC ACID FROM THE ORGANIC ACID SECRETORY SYSTEM

Front 38

ADVERSE EFFECTS OF LOOP DIURETICS INCLUDE

Back 38

HYPOKALEMIA AND HYPOMAGNESEMIA, HYPERURICEMIA, OTOTOXICITY, HYPOVALEMIA LEADING TO HYPOTENSION, SKIN RASH AND PHOTOSENSITIVITY

Front 39

WHAT TYPE OF SYMPTOMS MIGHT OCCUR IN A PERSON WITH SULFA ALLERGIES AFTER TAKING A LOOP DIURETIC?

Back 39

SKIN RASH, ALLERGIC REACTION, AND PHOTOSENSITIVITY

Front 40

WHAT IS THE SITE OF ACTION OF THIAZIDE DIURETICS?

Back 40

THE DISTAL CONVOLUTED TUBULE

Front 41

THE CELLS IN THE DCT ARE ______________ TO WATER

Back 41

IMPERMEABLE

Front 42

THIAZIDE DIURETICS CONTAIN SULFA SO PATIENTS WITH AN ALLERGY SHOULD BE GIVEN WHAT DRUG

Back 42

THE LOOP DIURETIC ETHACRYNIC ACID

Front 43

WHAT IS THE MECHANISM OF ACTION OF THIAZIDE DIURETICS?

Back 43

REDUCE REABSORPTION OF SODIUM IN THE DISTAL TUBULE WHICH CAUSES LESS REABSORPTION OF WATER AND THUS INCREASED DIURESIS

Front 44

HOW DO THIAZIDE DIURETICS ARRIVE AT THE KIDNEY?

Back 44

BY THE ORGANIC SECRETORY SYSTEM (THAT IS WHY YOU USE CAUTION IN PATIENTS WITH GOUT BECAUSE THIS SYSTEM ALSO DELIVERS URIC ACID)

Front 45

CLINICAL USES OF THIAZIDE DIURETICS

Back 45

HYPERTENSION, CHF, HYPERCALCICURIA (KIDNEY STONES)

Front 46

WHY WOULD YOU USE THIAIZIDE DIURETIC IN PEOPLE WITH HYPERCALCICURIA OR KIDNEY STONES?

Back 46

IT INCREASES THE ABSORPTION OF CALCIUM FROM THE URINE BACK INTO THE BODY

Front 47

ADVERSE EFFECTS OF THIAZIDE DIURETICS

Back 47

POTASSIUM DEPLETION; HYPERURICEMIA, PHOTOSENSITIVITY, SMALL ADVERSE EFFECT ON LIPID PROFILE, HYPERGLYCEMIA

Front 48

MOST COMMON THIAZIDE

Back 48

HYDROCHLOROTHIAZIDE (HCTZ, ESIDRIX,ORETIC, HYDRODIURIL)

Front 49

THIS NON THIAZIDE DIURETIC HAS LESS EFFECT IN THE LIPID PROFILE AND LESS LIKELY TO CAUSE HYPERGLYCEMIA

Back 49

INDAPAMIDE (LOZOL)

Front 50

ALTHOUGH THESE DRUGS DO CAUSE HYPERGLYCEMIA THEY ARE NOT CONTRAINDICATED IN DIABETES

Back 50

THIAZIDE DIURETICS

Front 51

WHY DO THIAZIDE DIURETICS CAUSE HYPERGLYCEMIA AS AN ADVERSE AFFECT?

Back 51

THEY CAUSE LOW POTASSIUM SO THERE IS DIMINISHED ABILITY TO MOVE GLUCOSE INTO CELLS FROM THE BLOOD

Front 52

WHAT IS THE INDICATION FOR METOLAZONE?

Back 52

USE IN PATIENTS THAT NEED A THIAZIDE DIURETIC BUT THAT HAVE POOR RENAL FUNCTION (GFR BELOW 300)

Front 53

WHAT HAPPENS WHEN ALDOSTERONE RECEPTORS IN THE COLLECTING TUBE AND DUCTS ARE STIMULATED?

Back 53

CAUSES NA REABSORPTION AND K SECRETION

Front 54

THIS IS THE SITE OF ACTION FOR THE POTASSIUM SPARING DIURETICS

Back 54

COLLECTING TUBULE AND DUCT

Front 55

WHAT IS ALDOSTERONISM?

Back 55

HIGH LEVEL OF ALDOSTERONE SECRETION

Front 56

THESE TWO DRUGS ARE ALDOSTERONE ANTAGONISTS?

Back 56

SPIRONOLACTONE (ALDACTONE) AND EPLERENONE (INSPRA)

Front 57

WHAT IS THE MOA FOR TRIAMTERENE (DYRENIUM) AND AMILORIDE (MIDAMOR)?

Back 57

INHIBIT NA FLUX THRU THE ION CHANNEL IN THE LUMEN MEMBRANE (IN THE COLLECTING DUCT AND TUBULE); THUS INHIBIT NA REABSORPTION AND K SECRETION

Front 58

WHAT IS THE CLINICAL USE OF POTASSIUM SPARING DIURETICS (AST)?

Back 58

HYPERTENSION IN CONJUNCTION WITH HYPOKALEMIA, PRIMARY OR SECONDARY ALDOSTERONISM

Front 59

ADVERSE REACTIONS OF K SPARING DIURETICS

Back 59

HYPERKALEMIA

Front 60

THIS SIDE EFFECT IS PARTICULAR TO SPIRONOLACTONE (A POTASSIUM SPARING DIURETIC)

Back 60

GYNECOMASTIA AND MENSTRUAL IRREGULARITIES

Front 61

WHAT TWO OVERLAPPING MECHANISMS CONTROL CARDIAC OUTPUT AND PERIPHERAL RESISTANCE?

Back 61

SYMPATHETIC NERVOUS SYSTEM AND RAAS

Front 62

WHEN BARORECEPTORS IN THE KIDNEY SENSE REDUCED ARTERIAL PRESSURE, WHAT DO THEY DO?

Back 62

RELEASE THE ENZYME RENIN

Front 63

WHAT IS THE FUNCTION OF ANGIOTENSIN II?

Back 63

STIMULATES ALDOSTERONE SECRETION WHICH CAUSES RENAL SODIUM REABSORPTION

Front 64

WHAT IS THE MOA OF SPIRONOLACTONE AND EPLERENONE IF THEY ARE ALDOSTERONE ANTAGONISTS?

Back 64

ALDOSTERONE NORMALLY CAUSES NA AND WATER SAVING, SO IF ALDOSTERONE IS INHIBITED, K WILL BE SPARED AND NA AND H2O WILL GO OUT IN URINE

Front 65

SPIRONOLACTONE IS THE K SPARING DIURETIC THAT IS APPROVED FOR WHAT CONDITION?

Back 65

HEART FAILURE

Front 66

WHY DOES SPIRINOLACTONE REDUCE THE RISK OF DEATH AND HOSPITALIZATION IN PATIENTS WITH SEVERE HEART FAILURE

Back 66

NOT BECAUSE OF ITS DIURETIC EFFECT BUT BECAUSE IT BLOCKS ALDOSTERONE WHICH PROMOTES FIBROSIS

Front 67

ALDOSTERONE ANTAGONISTS WOULD BE USED IN CONJUNCTION WITH WHAT DRUG IN HF?

Back 67

ACE INHIBITORS

Front 68

WHAT DOES ALDOSTERONE DO TO THE HEART AND BLOOD VESSELS?

Back 68

STIFFENS THEM

Front 69

WHEN A PATIENT IS TAKING AN ACE INHIBITOR WITH SPIRONOLACTONE, WHAT DO YOU MONITOR LEVELS OF?

Back 69

POTASSIUM LEVELS

Front 70

WHAT IS THE NAME OF THE OSMOTIC DIURETIC?

Back 70

MANNITOL

Front 71

WHAT TWO OVERLAPPING MECHANISMS CONTROL CARDIAC OUTPUT AND PERIPHERAL RESISTANCE?

Back 71

SYMPATHETIC NERVOUS SYSTEM AND RAAS

Front 72

WHEN BARORECEPTORS IN THE KIDNEY SENSE REDUCED ARTERIAL PRESSURE, WHAT DO THEY DO?

Back 72

RELEASE THE ENZYME RENIN

Front 73

WHAT IS THE FUNCTION OF ANGIOTENSIN II?

Back 73

STIMULATES ALDOSTERONE SECRETION WHICH CAUSES RENAL SODIUM REABSORPTION

Front 74

WHAT IS THE MOA OF SPIRONOLACTONE AND EPLERENONE IF THEY ARE ALDOSTERONE ANTAGONISTS?

Back 74

ALDOSTERONE NORMALLY CAUSES NA AND WATER SAVING, SO IF ALDOSTERONE IS INHIBITED, K WILL BE SPARED AND NA AND H2O WILL GO OUT IN URINE

Front 75

SPIRONOLACTONE IS THE K SPARING DIURETIC THAT IS APPROVED FOR WHAT CONDITION?

Back 75

HEART FAILURE

Front 76

WHY DOES SPIRINOLACTONE REDUCE THE RISK OF DEATH AND HOSPITALIZATION IN PATIENTS WITH SEVERE HEART FAILURE

Back 76

NOT BECAUSE OF ITS DIURETIC EFFECT BUT BECAUSE IT BLOCKS ALDOSTERONE WHICH PROMOTES FIBROSIS

Front 77

ALDOSTERONE ANTAGONISTS WOULD BE USED IN CONJUNCTION WITH WHAT DRUG IN HF?

Back 77

ACE INHIBITORS

Front 78

WHAT DOES ALDOSTERONE DO TO THE HEART AND BLOOD VESSELS?

Back 78

STIFFENS THEM

Front 79

WHEN A PATIENT IS TAKING AN ACE INHIBITOR WITH SPIRONOLACTONE, WHAT DO YOU MONITOR LEVELS OF?

Back 79

POTASSIUM LEVELS

Front 80

WHAT IS THE NAME OF THE OSMOTIC DIURETIC?

Back 80

MANNITOL

Front 81

WHY DO THIAZIDE DIURETICS CAUSE HYPERGLYCEMIA AS AN ADVERSE AFFECT?

Back 81

THEY CAUSE LOW POTASSIUM SO THERE IS DIMINISHED ABILITY TO MOVE GLUCOSE INTO CELLS FROM THE BLOOD

Front 82

WHAT IS THE INDICATION FOR METAZOLONE?

Back 82

USE IN PATIENTS THAT NEED A THIAZIDE DIURETIC BUT THAT HAVE POOR RENAL FUNCTION (GFR BELOW 300)

Front 83

WHAT HAPPENS WHEN ALDOSTERONE RECEPTORS IN THE COLLECTING TUBE AND DUCTS ARE STIMULATED?

Back 83

CAUSES NA REABSORPTION AND K SECRETION

Front 84

THIS IS THE SITE OF ACTION FOR THE POTASSIUM SPARING DIURETICS

Back 84

COLLECTING TUBULE AND DUCT

Front 85

WHAT IS ALDOSTERONISM?

Back 85

HIGH LEVEL OF ALDOSTERONE SECRETION

Front 86

THESE TWO DRUGS ARE ALDOSTERONE ANTAGONISTS?

Back 86

SPIRONOLACTONE (ALDACTONE) AND EPLERENONE (INSPRA)

Front 87

WHAT IS THE MOA FOR TRIAMTERENE (DYRENIUM) AND AMILORIDE (MIDAMOR)

Back 87

INHIBIT NA FLUX THRU THE ION CHANNEL IN THE LUMEN MEMBRANE (IN THE COLLECTING DUCT AND TUBULE); THUS INHIBIT NA REABSORPTION AND K SECRETION

Front 88

WHAT IS THE CLINICAL USE OF POTASSIUM SPARING DIURETICS (AST)?

Back 88

HYPERTENSION IN CONJUNCTION WITH HYPOKALEMIA, PRIMARY OR SECONDARY ALDOSTERONISM

Front 89

ADVERSE REACTIONS OF K SPARING DIURETICS

Back 89

HYPERKALEMIA

Front 90

THIS SIDE EFFECT IS PARTICULAR TO SPIRONOLACTONE (A POTASSIUM SPARING DIURETIC)

Back 90

GYNECOMASTIA AND MENSTRUAL IRREGULARITIES

Front 91

WHAT TWO OVERLAPPING MECHANISMS CONTROL CARDIAC OUTPUT AND PERIPHERAL RESISTANCE?

Back 91

SYMPATHETIC NERVOUS SYSTEM AND RAAS

Front 92

WHEN BARORECEPTORS IN THE KINDEY SENSE REDUCED ARTERIAL PRESSURE, WHAT DO THEY DO?

Back 92

RELEASE THE ENZYME RENIN

Front 93

WHAT IS THE FUNCTION OF ANGIOTENSIN II?

Back 93

STIMULATES ALDOSTERONE SECRETION WHICH CAUSES RENAL SODIUM REABSORPTION

Front 94

WHAT IS THE MOA OF SPIRONOLACTONE AND EPLERENONE (THEY ARE ALDOSTERONE ANTAGONISTS)?

Back 94

ALDOSTERONE NORMALLY CAUSES NA AND WATER SAVING, SO IF ALDOSTERONE IS INHIBITED, K WILL BE SPARED AND NA AND H2O WILL GO OUT IN URINE

Front 95

SPIRONOLACTONE IS THE K SPARING DIURETIC THAT IS APPROVED FOR WHAT CONDITION?

Back 95

HEART FAILURE

Front 96

WHY DOES SPIRINOLACTONE REDUCE THE RISK OF DEATH AND HOSPITALIZATION IN PATIENTS WITH SEVERE HEART FAILURE

Back 96

NOT BECAUSE OF ITS DIURETIC EFFECT BUT BECAUSE IT BLOCKS ALDOSTERONE WHICH PROMOTES FIBROSIS

Front 97

ALDOSTERONE ANTAGONISTS WOULD BE USED IN CONJUNCTION WITH WHAT DRUG IN HF?

Back 97

ACE INHIBITORS

Front 98

WHAT DOES ALDOSTERONE DO TO THE HEART AND BLOOD VESSELS?

Back 98

STIFFENS THEM

Front 99

WHEN A PATIENT IS TAKING AN ACE INHIBITOR WITH SPIRONOLACTONE, WHAT DO YOU MONITOR LEVELS OF?

Back 99

POTASSIUM LEVELS

Front 100

WHAT IS THE NAME OF THE OSMOTIC DIURETIC?

Back 100

MANNITOL

Front 101

HOW DOES MANNITOL WORK?

Back 101

IT INCREASES THE OSMOTIC PRESSURE OF GLOMERULAR FILTRATE INHIBITING TUBULAR REABSORPTION OF H20 AND ELECTROLYTES, THEREBY INCREASING URINARY OUTPUT

Front 102

WHAT IS THE CLINICAL USE OF MANNITOL?

Back 102

PROMOTES URINARY EXCRETION OF TOXIC SUBSTANCES, DIURESIS IN ACUTE RENAL FAILURE, AND DECREASED INTRACRANIAL PRESSURE ASSOCIATED WITH CEREBRAL EDEMA

Front 103

WHAT IS THE CONTRAINDICATION FOR MANNITOL?

Back 103

AVOID USE IN ACTIVE INTRACRANIAL BLEEDS