Pharm- Renal System

Front 1

Renin release by the JG cells is stimulated by what means? How does this explain one of the mechanisms by which beta blockers are thought to help reduce hypertension?

Back 1

Renin is stimulated to be released from the JG cells through decreased BP in the afferent arteriole, decreased Na+ delivery to the Macula Densa, and Increased sympathetic tone. Inhibiting this last mechanism, and inhibiting renin secretion, is thought to be one mechanism by which beta blockers help to reduced hypertension.

Front 2

Prostaglandins PGE2/PGI2 vasodilate the afferent arterioles in the kidneys, but they also modulate (stimulate) the release of what other molecule?

Back 2

Postaglandins also modulate the release of Renin in the kidney.

Front 3

How does Aldosterone promote Na+ and H2O reabsorption?

Back 3

Aldosterone does this through increased expression of Na+ channels on the lumenal side of the principle cells of the collecting ducts

Front 4

Name four effects of ANGII stimulating AT1 receptors.

Back 4

Vasoconstriction, Cardiac hypertrophy, increased myocardial contractility, and increased release of neurotransmitters.

Front 5

Kininase is another name for what enzyme?

Back 5

ACE (Angiotensin Converting Enzyme).

Front 6

Name a drug-insensitive tissue enzyme that can convert ANGI to ANGII in the presence of an ACE inhibitor.

Back 6

Chymase.

Front 7

CAPTOPRIL is a nomogram for the side effects of ACE inhibitors. What does each letter stand for?

Back 7

Side Effect Mneumonic: Cough, Angioedema, Proteinuria, Taste changes, Orthostatic hypotension (or hypotension), Pregnancy problems (see below), Rash, Increased renin & lower angiotensin II & Lytes (for the electro-lyte disturbance of hyperkalemia)

Front 8

ACE inhibitors can lead to Acute Renal Failure in what specific situations?

Back 8

Renal artery stenosis, volume depletion, and elderly patients with CHF. (any condition where the rate of plasma flow or GFR is already low and dependent on ANGII to be maintained at a normal rate)

Front 9

What class of medication is best used as a monotherapy in patients that have mild forms of hypertension?

Back 9

Thiazide diruetics.

Front 10

What are the potassium sparring diuretics that we know about?

Back 10

Triameterene, Amiloride, and Spironolactone.

Front 11

Describe the metabolic changes that can be seen with the use of Thiazide diuretics.

Back 11

Hypokalemic metabolic alkalosis, hyperuricemia, hyperglycemia, and hyperlipidemia are primarily observed with doses higher than are the current standard of care with Thiazide diuretics.

Front 12

Which diuretic medication is used to treat hypercalcemia and which is used to treat hypercalcuria?

Back 12

Loop diruetics are used to treat hypercalcemia. Thiazides are used to treat hypercalcuria.

Front 13

These drugs were initially meant to be diuretics acting in the proximal tubule and inhibiting Na+ reabsorption, but they have weak action there. Still, they are useful in the treatment of glaucoma and in prophylactic treatment of acute mountain sickness.

Back 13

Carbonic anhydrase inhibitors (e.g. Acetazolamide)

Front 14

How do Alpha-1 Blockers work to relieve the symptoms of BPH faster than any other drugs?

Back 14

Alpha-1 Blockers have a rapid onset of action to relax smooth muscle in the bladder neck, and prostatic urethra, typically producing an acute relief of symptoms.

Front 15

Which selective Alpha-1 Blocker for BPH requires little titrating when given with with other medications that affect BP because of its specificity for the prostate Alpha-1 receptors?

Back 15

Tamsulosin.

Front 16

Lithium can cause what sort of renal dysfunction?

Back 16

Lithium can cause Nephrogenic Diabetes Insipidus

Front 17

Penicillin is associated with what sort of electrolyte disturbance?

Back 17

Penicillin is associated with Hypokalemia.