Step 1 Renal Drugs

Front 1

acetazolamide

Back 1

Mech: carbonic anhydrase inhibitor

Uses: Glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness

Toxicity: hyperchloremic metabolic acidosis, neuropothy, NH3 toxicity, sulfa allergy

Front 2

mannitol

Back 2

Mech: osmotic diuretic - increases urine flow
clinical use: shock (increase plasma volume), lower intracranial/intraocular pressure

Toxicity: pulmonary edema, dehydration. Do not use in anuria, CHF

Front 3

furosemide + 1

Back 3

Mech: Loop Diuretic, sulfonamide derivative, abolishes the medullary concentration gradient

Use: HTN, hypercalcemia, edematous states (CHF, cirrhosis etc)

Toxicity: OH DANG - ototoxicity, hypoK, dehydration, allergy to sulfa, Nephritis, Gout

Ethacrynic acid - like furosamide but not a sulfa derivative.

Front 4

hydrochlorothiazide

Back 4

Mech: inhibits Na/Cl transporter in DCT.

Use: hypercalcuria/stones, htn, fluid overload, nephrogenic DI (makes urine concentrated)

Toxicity: hypokalemic metabolic alkalosis (volume down --> aldo), hyperGLUC (lipid, glucose, calcemia, glycemia)

Front 5

K+ sparing diuretics

Back 5

the K+ STAys - spironolactone, triamterine, amiloride

Mech: Spironolactone comp inhibits aldosterone receptor, triamterine, amiloride act by blocking Na+ channels in the CCT.

Use: in conjunction with a loop or thiazide diuretic; for hyperaldosteronism

Toxicity: hyperkalemia, spironolactone causes gynecosmastia

Front 6

ACE inhibitors

Back 6

captopril, lisinopril, enalapril
Mech: inhibits ACE conversion of AT1 to AT 2 and prevents inactivation of bradykinin (a vasodilater). Renin levels go up

Clinical use: HTN, CHF, diabetic renal disease

Toxicity: CAPTOPRIL (cough, angioedema, proteinuria, taste changes, hypotension, pregnancy changes, rash, increased renin, lower angiotensin 2).
lower GFR