Renal Pharm

Front 1

Mannitol
1)MOA
2)Use
3)Toxicity

Back 1

1) Osmotic diuresis due to increasing fluid osmolarity

2) Decrease Intraocular Pressure, Decrease Cerebral Pressure, Cause urination in oliguric Renal Failure Pts, Manage Edema

3)Dehydration

Front 2

Acetazolamide
1)MOA
2)Use
3)Toxicity

Back 2

1) Inhibits Carbonic Anhydrase to cause self limiting diuresis of NaHCO3 in proximal tubule and loss of HCO3 stores

2)Glaucoma, Urinary Alkalinization, Metabloic Alkalosis, Altitude Sickness (compensate for Respiratory Acidosis)

3) Hyperchloremic metabolic acidosis, neuropathy, Sulfa Allergy, NH3 toxicity

Front 3

Furosemide
1)MOA
2)Use
3)Toxicity

Back 3

1)Sulfonamide loop diuretic that blocks Na-K-2Cl pump (they are lost in urine) which abolishes the gradient in the Renal Medulla --> prevents urine concentration --> loss of excess water, Na+, K+, Cl-, Mg+, Ca++ (Loops Lose Ca+)

2) Edema (CHF, cirrhosis, nephrotic syndrome, pulmonary edema), hypertension, hypercalcemia

3) OH DANG -
Ototoxic
Hypokalemia
Dehydration
Allergy (Sulfa)
Nephritis (interstitial)
Gout (loss of volume concentrates remaining uric acid)

Front 4

Ethacrynic Acid
1)MOA
2)Use
3)Toxicity

Back 4

1) Same as Furosemide but not a Sulfa Drug

2) Diuresis in pts with Sulfa Allergy

3) Acute Gouty attack

Front 5

Hydrochlorothiazide
1)MOA
2)Use
3)Toxicity

Back 5

1) Thiazide diuretic acting in early distal tubule. Inhibits NaCl reabsorption reducing the diluting ability of nephron (can't reabsorb as much water)
Also increased Ca+ reabsorption b/c no competition with NaCl

2)HTN, CHF, Hypercalciuria, Diabetes Insipidus

3) Hypokalemic Metabolic Alkalosis, Hyponatremia, hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia, Sulfa Allergy

Front 6

K+ Sparing Diuretics (Spironolactone, Amiloride, Triamterene)
1)MOA
2)Use
3)Toxicity

Back 6

1) Spironolactone blocks Aldo receptors to prevent Na+/H20 reabsorption and prevents K+ and H+ excretion.
Triamterene and Amiloride block Na+ channels in Cortical Collecting Tubule

2)Hyperaldosteronism, K+ depletion, CHF

3) Hyperkalemia, endocrine effects (gynecomastia, antiadrogen)

Front 7

Electrolyte Changes in Diuretics

1)Urine NaCl
2)Urine K
3)Blood pH
4)Urine Ca

Back 7

1) All increase urine NaCl
2) All increase urine K+ except K+ sparing
3) Acetazolamide, Spironolactone cause acidosis. Loop Diuretics and Thiazides cause Alkalosis (volume contraction)

4) Loop Diuretic increase Urine Ca+, the Thiazide decrease Urine Ca+