Renal Pharmacology Part 1

Front 1

What are the three molecules that the kidney secretes?

Back 1

erythropoietin, renin, and 1, 25- dihydroxyvitamin D

Front 2

Which cell in the kidney secretes renin?

Back 2

juxtaglomerular cells

Front 3

What cells sense sodium concentration in the plasma?

Back 3

macula densa cells

Front 4

What is the GFR of a normal adult?

Back 4

180 L/day or 125 mL/min

Front 5

Describe the absorption percentages of sodium as it travels through the nephron

Back 5

65% proximal tubule
25-35% in the ascending tubule
2-10% in the distal tubule
1-5% in the collecting duct

Front 6

Where does vasopressin act upon and what does it do?

Back 6

It acts on the collecting ducts and inserts aquaporins so that water is reabsorbed.

Front 7

Where is ADH secreted from?

Back 7

The posterior pituitary

Front 8

Where do carbonic anhydrase inhibitors work on in the nephron?

Back 8

The proximal tubule

Front 9

Why does acetazolamide have decreased efficiency after a few days?

Back 9

NaCl is compensated further along the tubules

Front 10

What are side effects of carbonic anhydrase inhibitors?

Back 10

hyperchloremic metabolic acidosis, kidney stones, and potassium wasting

Front 11

What is carbonic anhydrase inhibitors used to treat?

Back 11

alkalosis, glaucoma, mountain sickness, used to make urine basic

Front 12

Where in the nephron does loop diuretics work?

Back 12

Ascending limb of the loop of Henle

Front 13

How do loop diuretics work?

Back 13

They bind to NKCC2 transporters preventing sodium absorption

Front 14

Name the loop diuretics

Back 14

furosemide, torsemide, bumetamide, and ethacrynic acid

Front 15

What are loop diurectics used for?

Back 15

pulmonary edema, acute renal failure, anion overdose

Front 16

What are some side effects of loop diuretics?

Back 16

hypokalemic metabolic acidosis, ototoxicity, hypomagnesia, dehydration, ototoxicity (rate related), sulfa allergy

Front 17

Which loop diuretic has a higher incidence of ototoxity?

Back 17

ethacrynic acid

Front 18

Why is ethacrynic acid used even though it has higher ototoxicty risk?

Back 18

Some patients may be allergic to other loop diuretics

Front 19

Where do thiazide/thiazide-like diuretics work?

Back 19

distal convoluted tubule

Front 20

How do thiazide diuretics work?

Back 20

The bind to NCC1 transporter

Front 21

What drug can inhibit thiazide diuretics?

Back 21

NSAIDs

Front 22

What are thiazide/thiazide like diuretics used for?

Back 22

treat hypertension, heart failure, nephrolithiasis

Front 23

Why can thiazide diuretics be used to treat nephrogenic diabetes insipidus even though the use of the drug should exacerbate the problem?

Back 23

The drug increases the expression of Na+ transporters in the distal convoluted tubule and collecting duct, thus causes more Na+ to be reabsorbed and reduce urine production

Front 24

Where do potassium sparing diuretics work on in the nephron?

Back 24

in the collecting duct

Front 25

How does spirinolactone and eplerenone work?

Back 25

They bind to aldosterone receptors and prevent the expression of ENaC and Na+/K+ ATPase

Front 26

What do triamterene and amiloride work?

Back 26

They inhibit ENaC

Front 27

Potassium sparing diuretics can be inhibited by which drug?

Back 27

NSAIDs

Front 28

What are some side effects of potassium sparing diuretics?

Back 28

hyperkalemia, hyperchloremic metabolic acidosis

Front 29

What are the side effects of thiazide/thiazide-like diuretics?

Back 29

hypokalemia, metabolic alkalosis, hyperglycemia, hyperlipidemia, hyponatremia, sulfa allergy, impotence, and photosensitivity

Front 30

What diuretic causes gynecomastia?

Back 30

spirinolactone

Front 31

Is spirinolactone and indomethacin a good combination?

Back 31

No, it will cause acute renal failure

Front 32

What side effect is specific to triamterene of the potassium sparing diuretics?

Back 32

kidney stones

Front 33

What caution should be made when prescribing eplerenone?

Back 33

Not to prescribe with CYP3A4 inhibitors

Front 34

What is desmopressin acetate used for?

Back 34

central diabetes insipidis

Front 35

What is diabetes insipidis?

Back 35

A condition in which a person produces too much urine

Front 36

Which antidiuretic hormone antagonist is V2 specific?

Back 36

tolvaptan

Front 37

What are antidiuretic hormone antagonists used for?

Back 37

SIADH (syndrome of inappropriate ADH)

Front 38

What is the dosage route of conivaptan?

Back 38

IV only

Front 39

Where do osmotic diuretics work?

Back 39

proximal convoluted tubule and descending limb of loop of Henle

Front 40

How do osmotic diuretics work?

Back 40

they increase the intralumenal osmotic force. Causing water to stay in the lumen, this forces the sodium to stay in the lumen

Front 41

What are osmotic diuretics used for?

Back 41

intracranial pressure and increased solute load

Front 42

What are side effects of osmotic diuretics?

Back 42

dehydration, hyperkalemia, and hypernatremia

Front 43

What is isosorbide used for?

Back 43

glaucoma

Front 44

Can mannitol be taken orally?

Back 44

no, only used IV

Front 45

What are the core molecular elements of a carbonic anhydrase inhibitor?

Back 45

amide, sulfonamide, thiadiazole

Front 46

How is methazolamide different from acetazolamide?

Back 46

contains a methyl group near the amide group

Front 47

What are the core molecular elements of a thiazide diuretic?

Back 47

thiazide, sulfamoyl group, and electron withdrawing group

Front 48

What does saturation of a thiazide diuretic do?

Back 48

increases activity

Front 49

How do you increase potency and lipophilicity in thiazide diuretics?

Back 49

Add lipophilic group at the 3-C and alkyl groups and 2-N

Front 50

What is the core structure of metolazone?

Back 50

quinozolinone

Front 51

What is the core structure of chlorthalidone?

Back 51

Phthalimidine

Front 52

What is the core structure of indapamide?

Back 52

indoline

Front 53

What is the total body water in males and females?

Back 53

60% for males and 50% for females