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1-4 and 5 Flashcards

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1
Q

Which two drugs have a black box warning that state they cause myelination disorders?

A

Tolvaptan/Mozvaptan (V2 Receptor Antagonists)

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2
Q

Which drug class does Conivaptan belong to?

A

V1a/V2 Receptor Antagonists

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3
Q

Which drug class is best use for treating hypervolemic-hyponatremia due to SIADH?

A

Vasopressin Receptor Antagonists

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4
Q

Clinical indications for Vasopressin agonists?

A

1) Diabetes insipidus
2) Nocturia

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5
Q

What part of the kidney is critical for conserving water?

A

Collecting duct

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6
Q

When plasma Osm increases, so do vasopressin levels. How does this affect water permeability?

A

Increases water permeability by enhancing AQP2 localization in membrane

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7
Q
A
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8
Q

What is the major receptor in renal tissue (specifically: in the principal cells of the collecting duct and thick ascending limb)?

A

V2

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9
Q

How does vasopressin lead to translocation of AQP2 on membrane surface?

A

-Rise in cAMP and PKA

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10
Q

What drug class binds to NPR receptors, thereby triggering conversion of GTP to cyclic GMP?

A

Natriuretic Peptides (AMP, CMP, Urodilatin)

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11
Q

True or False: In the Natriuretic Peptide pathway, both cGMP and PKG inhibit the CNG (cyclic nucleotide gate channel) directly

A

True

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12
Q

True or False: In the Natriuretic Peptide pathway, PKG prevents Na exit via Na/K ATPase

A

True

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13
Q

___ is a recombinant BMPknown to inhibit cyclic nucleotide gated cation channel (CNGC)

A

Nesiritide

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14
Q

Regarding natriuretic peptides, what channel allows for Na/K/NH4 entry and is controlled by cGMP?

A

CNGC (cyclic nucleotide gated cation channel)

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15
Q

Where do Natriuretic Peptides act?

A

Inner medullary collecting duct

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16
Q

What drug is a MR specific antagonist with reduced non-specific effects?

A

Eplerenone

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17
Q

True or False: Since Thiazides can interfere w/other steroid receptors, they can cause impotence, hirsuitism, menstrual irregularities, etc.

A

False - Since MR Antagonists can interfere w/other steroid receptors, they can cause impotence, hirsuitism, menstrual irregularities, etc.

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18
Q

What drugs prevent aldosterone induced increased expression of ENaC mRNA and protein
A. Spironolactone/Eplerenone
B. Amiloride

A

A. Spironolactine/Eplerenone

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19
Q

How do MR Antagonists decrease mRNA expression of ENaC and promote degradation of ENaC

A

They stop NEDD 4/2 from being phosphoryalted - therefore ENaC is degraded

By inhibiting aldosterone, aldosterone cannot bind to MR, enter nucleus, and upregulate ENa

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20
Q
A

Delete me

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21
Q

True or False: Hypokalemia is an AE of K Sparing Diuretics

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A

False - hyperkalemia

22
Q

____ is one of the aldosterone induced proteins

23
Q

How does the aldosterone-MR complex produce proteins?

Study These Flashcards
A

Enters nucleus, homodimerizes, binds to responsive elements in DNA

24
Q

Which two drugs block ENaC channels?
Which two drugs are MR antagonists?

Study These Flashcards
A

ENaC: Amiloride/Triamterene
MR Antagonists: Spironolactone/Eplerenone

25
Amiloride and Triamterene are known to cause _____
hyperkalemia (worsened by NSAID's, ACE Inhibitors, and Trimethoprim)
26
Amiloride and Triamterene are contraindicated in what patient population?
Those with hypoaldosteronism
27
True or False: By inhibiting ENaC in late DCT and Collecting Duct, Triamterene and Amiloride spares K loss
True
28
True or False: Mineralcorticoid Receptor antagonists bring about decreased expression of ENaC
True
29
What cell types of the cortical collecting duct do K+ sparing diuretics and aldosterone act on?
Principal cells
30
Role of Principal Cells?
Reabsorb water and sodium; promote K secretion
31
Thiazides and ____ can cause polymorphic ventricular tachy
Quinidine
32
Indapamide, Chlorthalidone, and Metolazone belong to what drug class?
Thiazides
33
What differentiates Na/Cl symporter inhibitors from Loop Diuretics?
-Thiazides have minimal effect on GFR, renin release, or RAAS activation because they act at a site PAST macula densa cells
34
Where are Na/Cl- symporters located?
Distal Convoluted Tubule
35
Describe the epithelium in the DCT?
Tight, minimal water permeability
36
What type of diuretics may cause ototoxicity?
Loop Diuretics - Interference of ionic conductance
37
True or False: Loop Diuretics can lead to sympathetic reflex and, ultimately, RAAS pathway activation
True
38
How does inhibition of Na/K/2Cl Symporter affect potential difference across epithelial cells?
Reduces potential difference - Could cause decrease calcium and magnesium reabsorption
39
Where do osmotic diuretics act?
Loop of henle and PCT (water permeable membranes)
40
___ acts an an inert agent, increasing Osm and promoting water loss in lumen
Mannitol
41
True or False: Loop of Henle is site of action for osmotic and loop diuretics
True
42
Systemic metabolic acidosis is associated with which drug class?
CA Inhibitors
43
What are two examples of CA Inhibitors?
1) Acetazolamide 2) Methazolamide
44
What do CA Inhibitors prevent?
1) CO2 uptake - decreases carbonic acid break down 2) indirectly decreases amount of sodium reabsorbed from luminal fluid
45
In the lumen/brush border, H2CO3 decomposes rapidly to CO2 and water in the presence of which CA Enzyme?
CA Type 4
46
Which CA Enzyme acts within the cytoplasm to breakdown carbonic acid into HCO3 and H+?
CA Type II
47
True or False: Carbonic Anhydrase plays a role in HCO3 reabsorption and acid excretion
True
48
Where are CA enzymes primarily located?
PCT
49
Denser microvilli are found in the apical membrane of the ___ tubule, which allows for greater solute absorption The collecting duct contains ___ epithelia
proximal tight
50
How do diuretics treat HTN?
- Promotes diuresis/natriuresis - Decrease hypervolemia/hypernatremia - Decrease pre-load
51
How are diuretics used to treat heart failure?
Reduce edema and congestion

Pharmacology (53 decks)

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