Renal Pharmacology For Step 1

Front 1

acetazolamide
mechanism:
uses:
toxicity:

Back 1

- acts @ proximal tubule. carbonic anhydrase inhibitor.
- increased excretion of NaHCO3 and reduction in total HCO3- stores
- used for: glaucoma, metabolic alkalosis,
- toxicity: met. acidosis, NH3 tox, neuropathy, SULFA ALLERGY

Front 2

mannitol
mechanism:
uses:
toxicity:

Back 2

-osmotic diuretic, increase tubular fluid osmolarity
- uses: shock, decrease intracranial/ intraocular pressure
- tox: pulm edema, dehyrdation,

Front 3

furosemide
mechanism:
uses:
toxicity:

Back 3

- acts at thick ascending limb (sulfonamide loop diuretic)
- inhibits Na/K/2Cl cotransporter (abolishes hypertonicity of the medulla, preventing concentration of urine)
- calcium excretion increased
- uses: edematous states (CHF, cirrhosis), HTN, hypercalcemia
- tox: ototoxicity, hypokalemia, GOUT, SULFA ALLERGY (use ethacrynic acid if allergic to sulfa drugs),

Front 4

hydrocholorothiazide
mechanism:
uses:
toxicity:

Back 4

- inhibits NaCl reabsorption in early distal tubule (inhibit the Na/Cl contransporter)
- decreases calcium excretion so hypercalcemia is a potential complication
- used for HTN, CHF, idiopathic hypercalcuria, nephrogenic diabetes inspidus
- tox: hypokalemic metabolic ALKalosis, hyponatremia, hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia, SULFA ALLERGY

Front 5

K sparing- spironolactone, triamterene, amiloride, eplerenone
mechanism:
uses:
toxicity:

Back 5

- sprinolactone is a aldosterone receptor ANTAGonist
- amiloride & triamterene block Na channels in the collecting duct
- uses: hyperaldosteronism, CHF
- tox: hyperkalemia, sprinolactone causes gynecomastia

Front 6

ACE inhibitors- captopril, enalpril, lisinopril
mechanism:
uses:
toxicity:

Back 6

- inhibit ACE, reducing angiotensin II levels, and preventing inactivation of bradykinin (vasodilator)
- renin release will be increase due to (-) feedback
IT CAN CAUSE RENAL FAILURE IN PEEPS W/ FUCKED UP KIDNEYS
- uses: HTN, CHF, diabetic renal disease
-tox: famous cough, angioedema, taste changes, proteinuria, hypotension, increased renin, hyperkalemia, NO NO for preggies cuz it causes fetal renal damage

Front 7

which types of diuretics can cause hypercalcemia?

Back 7

thiazides
- thiazides decrease Ca excretion
- mech: they block NaCl absorption in DCT which increases the Na gradient which likely increases the activity of the Na/Ca exchange

Front 8

which diuretics INcrease calcium excretion and therfore could cause a hypocalcemia

Back 8

-loop diuretics
-abolish lumen (+) potential in the TAL of loop of Henle, this decreases paracellular Ca reabsorption which lead to increased urinary Ca and hypocalcemia

Front 9

which diuretics can cause acidema

Back 9

acetozolamide- carbonic anhydrase inhibitor
- also decreases excretion of H (in the form of NH4+)

Front 10

which diuretics can cause alkalemia

Back 10

- loops & thiazides