Usmle Pharmacology- Renal

Front 1

Prostaglandins Dilate ________ arteriole

Back 1

afferent
* Increase RPF
* Increase GFR

Front 2

NSAID constrict _______ arteriole

Back 2

afferent

Front 3

ATII constricts _______ arteriole

Back 3

efferent
* decrease RPF
* Increase GFR

Front 4

Mannitol:

Back 4

MOA: osmostic diuretic; Increase TF osmolarity

Use: Shock; drug overdose; decrease intracranial pressure

Toxic: Pulm Edema; dehyration;

Front 5

What is mannitol contraindicated in?

Back 5

- anuria
- CHF

Front 6

Acetazolamide:

Back 6

MOA: CA inhibitor

Use: Glaucoma; urinary alkalination; metabolic alkalosis; altitude sickness

Toxic: Metabolic acidosis; neurpathy; NH3 toxicity; Sulfa allergy

Front 7

Furosemide:

Back 7

MOA: sulfonamide loop diuretic; inhibit cotransport of TAL;
"Loops lose calcium"

Use: Edema; HTN; hypercalcemia

Toxic: OH DANG
Ototoxicity
Hypokalemia
Dehydration
Allergy (sulfa)
Nephritis
Gout

Front 8

Ethacrynic acid:

Back 8

MOA: Phenoxyaceti acid--> NOT SULFONAMIDE
SAME ACTION AS FUROSEMIDE

Use: Diuresis in sulfa-allergic patients

Toxic: acute GOUT

Front 9

Hydrochlorothiazide:

Back 9

MOA: Thiazide diuretic; inhibit NaCL reabsoprtion in early distal tubule
DECREASE CA+ excretion

USE: HTN, CHF, Hypercalciuria, NEPHROGENIC DI

TOXIC: Hyper GLUC
Hypokalemic metabolic alkalosis
Hyponatremia
hyperGlyccemia
hyperLipidemia
hyperUricemia
hyperCalcemia

SULFA ALLERGY

Front 10

K+ sparing Diuretic:
- STAys:
Spironolactone
Triamterene
Amiloride
eplerenone

Back 10

MOA: competitive Aldosterone receptor antagonist in collecting tubule

Triamterne + Amiloride: block Na+ channels in CGT

Use: hyperaldosteronism; K+ depletion; CHF

Toxic: Hyperkalemia; gynecomastia; antiandrogen effects

Front 11

Diuretics _____ urine NaCL

Back 11

increase

Front 12

Diuretics _____ urine K+

Back 12

increase
*except K+ sparing diuretics

Front 13

Diuretics _____ blood pH

Back 13

decrease (acidemia): CA inhibitors, Ka+ sparing

increase (alkalemia): Loop diuretics and thiazides

Front 14

Diuretics ______ urine Ca+

Back 14

increase: loop diuretics

decrease: thiazides

Front 15

ACE inhibitors

Back 15

MOA: inhibit ACE; prevent inactivation of bradykinin(dilator); HIGH renin release due to feedback

USE: HTN, CHF, diabetic renal disease; Post-MI

Toxic: CAPTOPRIL
Cough
Angioedema
Proteinuria
Taste changes
hypOtension
Pregnancy problem
Rash
Increased Renin
Lower AT II
Hyperkalemia

Front 16

Why should you avoid ACE inhibitors in bilateral renal artery stenosis?

Back 16

ACE inhibitors decrease GFR preventing constriction of efferent arterioles

Front 17

ACE inhibitor affects:

Back 17

- increase CO
- increase arteriolar dilation
- decrease afterload
- decrease preload

Front 18

C1 Esterase deficiency=

Back 18

ANGIOEDEMA

Front 19

Losartan affects:

Back 19

- decrease aldosterone
- increase renin
- increast ATI
- increase ATII

Front 20

Alcohol withdrawal treatment:

Back 20

Benzodiazepine

Front 21

Anorexia/Bulimia Treatment:

Back 21

SSRI

Front 22

Anxiety treatment:

Back 22

Benzodiazepine
Buspirone
SSRI

Front 23

ADHD treatment

Back 23

Methylphenidate
Amphetamine

Front 24

Atypical depression treatment

Back 24

MAO inhibitor
SSRI

Front 25

Bipolar disorder treatment

Back 25

Mood stabilizers
- Lithium
- Valproic acid
- Varbamazepine
- Atypical Antipsychotic

Front 26

Depression treatment

Back 26

SSRI
SNRI
TCA

Front 27

Depression with insomnia treatment

Back 27

Mirtazapine

Front 28

OCD treatment

Back 28

SSRI
Clomipramine

Front 29

Panic Disorder Treatment

Back 29

SSRI
TCA
Benzodiazepine

Front 30

PTSD treatment

Back 30

SSRI

Front 31

Schizophrenia treatment

Back 31

Antipysychotic

Front 32

Tourette Syndrome Treatment

Back 32

Antipsychotics (HALOPERIDOL)

Front 33

Social phobias treatment

Back 33

SSRI

Front 34

Methylphenidate:

Back 34

MOA: Increase presynaptic NE release

Use: ADHD

Front 35

What are the typical antipsychotics?

Back 35

Haloperidol
Trifluoperazine
Fluphenazine
Thioridazine
Chlorpromazine
Haloperidol

Front 36

Typical Antipsychotics:

Back 36

MOA: block D2 receptors

Use: schizophrenia, psychosis, mania, Tourette

Toxic:
1) Highly lipid soluble-- stored in body fat
2) EPS side effects
3) Dopamine receptor antagonism: hyperprolactinemia--> galactorrhea
4) Block muscarinic, alpha, histamine receptors

Front 37

What is NMS? (Neuroleptic Malignant syndrome)

Back 37

-rigidity
-myoglobinuria
-autonomic instability
-hyperpyrexia

Front 38

How do you treat NMS?

Back 38

Dantrolene
Bromocriptine

Front 39

What is Tardive Dyskinesia?

Back 39

-oral-facial movements due to long term antipsychotics

Front 40

What do you use for LSD treatment?

Back 40

haloperidol

Front 41

Schizophrenia has high levels of:

Back 41

- dopamine
- serotonin

Front 42

Which Dopamines activate AC?

Back 42

D1, D5

Front 43

which Dopamines inhibit AC?

Back 43

D2, D3, D4

Front 44

High Potency typical antipsychotics:

Back 44

- haloperidol
- trifluoperazine
- fluphenazine

Neurological side effects

Front 45

Low potency typical antipsychotics:

Back 45

- chlorpromazine

Non-neurological side effects

Front 46

What has corneal deposits?

Back 46

Chlorpromazine

Front 47

What has reTinal deposits?

Back 47

Trhioridazine
(also acardiotoxicity)

Front 48

What are EPS side effects?

Back 48

4 h acute dystonia
4 d akinesia
4 wk akathisia
4 mo tardive dyskinesia

Front 49

NMS symptoms:

Back 49

FEVER
Fever
Encephalopathy
Vital unstable
Elevated enzymes
Rigidity

Front 50

What are atypical antipyshcotics?

Back 50

"it's atypical for old closets to quietly risper from A to Z"
Olanzapine
Clozapine
Quetiapine
Risperidone
Ariprpirazole
Ziprasidone

Front 51

What is major side effect of Ziprasidone?

Back 51

Prolong QT interval

Front 52

Atypical antipsychotics:

Back 52

MOA: block 5HT, alpha, H1, dopamine receptors

Front 53

What is olanzapine used for?

Back 53

schizophrenia
OCD
anxiety
depression
mania
Tourette

Front 54

What atypical antipsychotics cause weight gain

Back 54

Olanzapine/Clozapine

Front 55

What are side effects of clozapine?

Back 55

weight gain
agranulocytosis--> NEED WBC checks
seizures

Front 56

What does risperidone side effect ?

Back 56

Hyperprolactinemia

Front 57

Lithium:

Back 57

MOA: inhibit PIP-->cAMP decreased

Use: bipolar; SIADH

Front 58

SIADH is treated with:

Back 58

LITHIUM
(ADH antagonist)

Front 59

What are toxicity of LITHIUM?

Back 59

LMNOP
Lithium
Movement
Nephrogenic DI
HypOthyroidism
Preganncy problems

Front 60

While on LITHIUM, you must monitor:

Back 60

THYROID FUNCTIONS

Front 61

Lithium causes this pregnancy defect:

Back 61

Ebastein Anomaly--> atrialization of RV

Front 62

Buspirone:

Back 62

MOA: 5HT1A agonist

USE: Generalized anxiety disorder

** takes 2 weeks to occur

Front 63

Antidepressents effects:

Back 63

- increase NE
- increase 5HT

Front 64

All antidepressants lower threshold for:

Back 64

seizures

Front 65

All antidepressants have black box warning of:

Back 65

increased suicide risk in youth

Front 66

TCA:

Back 66

-imipramine
-amitriptyline
-desipramine
-nortriptyline
-clomipramine
-doxepine
-amoxapine

Front 67

TCA mechanism:

Back 67

block reuptake of NE and Seratonin

Front 68

What are uses of TCA?

Back 68

- major depression
- migraine
- bedwetting
- OCD
- fibromyalgia

Front 69

what are side effects of TCA?

Back 69

- sedation
- alpha block affects

Front 70

Which TCA used in bedwetting?

Back 70

Imipramine

Front 71

Which TCA is used in OCD?

Back 71

clomipramine

Front 72

Which TCA is used in fibromyalgia?

Back 72

Amitriptyline

Front 73

What is toxicity of TCA?

Back 73

- Tri'C;s:
Convulsion
Coma
Cardiotoxicity (arrhythmia)
Repiratory depression

Front 74

How do you treat TCA toxicity?

Back 74

NaHCO3

Front 75

What are SNRI?

Back 75

venlafexine
duloxetine

Front 76

SNRI:

Back 76

MOA: inhibit sertonin and NE reuptake

USE: Depression

Front 77

What is Duloxetine also used for?

Back 77

diabetic peripheral neuropathy

Front 78

What is toxicity of SNRI?

Back 78

Increased BP

Front 79

MAOI:

Back 79

-phenelzine
-tranylcypromine
- isocarboxacid
- selegiline (Selective MAO-B inhibitor)

Front 80

MAOI:

Back 80

MOA: nonselective MAO inhbiitor: increase amine NT

Use: atypical depression, anxiety, hypochondriasis

Front 81

What is MAOI toxicity?

Back 81

- hypertensive crisis: tyramine ingestion

Front 82

Do not use MAOI in people taking:

Back 82

- SSRI
- Meperidine

Otherwise, serotonin syndrome occurs

Front 83

Hypochondriasis treatment:

Back 83

MAOI

Front 84

What are atypical antidepressants

Back 84

- burpopion
- mirtazapine
- maprotiline
- trazodone

Front 85

Bupropion:

Back 85

- used for smoking cessation also

- increase NE and Dopamine

Toxic: seizure in bulimic patients

Front 86

Mirtazapine:

Back 86

- alpha 2 antagonist

- increase NE and serotonin

- potent 5HT2 and 5HT3 antagonist

Toxic: sedatio, increased appetite, weight gain

Front 87

Maprotiline:

Back 87

MOA: block NE reuptake

Toxic: orthostatic hypotension

Front 88

Trazodone:

Back 88

MOA: inhibit serotonin reuptake

USE: insomnia

Toxic: priapism, postural hypotension

Front 89

What treats serotonin syndrome?

Back 89

Cyproheptadine

5HT2 receptor antagonist

Front 90

Benzodiazepine toxicity treatment:

Back 90

flumazenil

GABA antagonist

Front 91

SSRI:

Back 91

- fluoxetine
-paroxetine
- sertraline
- citalopram

Front 92

SSRI FACTS:

Back 92

MOA: SSRI

Use: depression, OCD, bulimia, social phobias

Side effects: GI distress, sexual dysfunction

Front 93

Serotonin syndrome:

Back 93

hyperthermia
muscle rigidity
CV collapse
flushing
diarrhea
seizures

Front 94

What is used to treat bulimia?

Back 94

SSRI