2nd mid term Flashcards

1
Q

Location of action: Acetazolamide

A

PCT

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2
Q

Actions: Acetazolamide

A

Loss of NaHCO3 -> Diureses
Metabolic acidosis
K+ wasting

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3
Q

Why will we see K+ wasting with Acetazolamide?

A

Excess Na+ is reabsorbed in the collecting duct in exchange for K+

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4
Q

When will we give Acetazolamide in case of diuresis?

A

Only if edema comes together with metabolic alkalosis

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5
Q

Location of action: Mannitol

A

PCT

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6
Q

Side effects: Mannitol

A

Pulmonary edema
HF exacerbation
Na+ inbalanace

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7
Q

Location of action: Loop diuretucs

A

Thick ascending limb

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8
Q

MOA: Acetazolamide

A

Inhibition of CA

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9
Q

MOA: Loop diuretucs

A

Inhibition of Na+/K+/2Cl- at the luminal side

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10
Q

Which drugs interact with Loop diuretics?

A

NSAID’s
Aminoglycosides
Lithium
Digoxin

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11
Q

Actions: Loop diuretucs

A

Natriuresis
Loss of lumen + potential -> Loss of Mg+ and Ca+ reab.
K+ and H+ wasting
Hypokalemic metabolic acidosis
COX-2 activation -> Increased GFT and systemic vasodilation

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12
Q

When will we give: Loop diuretucs

A

HF
Pukmonary edema
HTN
Acute renal failure

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13
Q

Side effects: Loop diuretucs

A
Sulfonamide
Hypovolemia
Ototoxicity
Hypocalcemia
Hypomagnesemia
Hypokalemic metabolic acidosis
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14
Q

Names: Loop diuretucs

A

Furosemide

Ethacrynic acid

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15
Q

What is special about Ethacrynic acid

A

Not a Sulfa drug

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16
Q

Location of action: Thiazides

A

Distal convoluted tubule

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17
Q

MOA: Thiazides

A

Inhibition of Na+/Cl- transporter

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18
Q

Names: Thiazides

A

Hydrochlorothiazide

Indapamide

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19
Q

Drug interaction: Hydrochlorothiazide

A

Digoxin

DM patients

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20
Q

When to give: Hydrochlorothiazide

A
HTN
CHF
Nephrolithiasis
Nephrogenic DI
Osteoporosis
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21
Q

Actions: Thiazides

A

Natriuresis
Hypercalcemia
K+ wasting

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22
Q

Which diretics causes hypocalcemia?

A

Loop diuretics

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23
Q

Which diretics causes hypercalcemia?

A

Thiazides

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24
Q

MOA: K+ sparing diuretics (2)

A

Aldosteron receptor inhibitors

ENaC inhibitors

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25
Q

Names: Aldosteron receptor inhibitors

A

Spironolactone

Eplerenone

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26
Q

Duration of action: Spironolactone

A

24-48 h

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27
Q

Indications: Aldosteron receptor inhibitors

A

Hyperaldestronism
Hypokalemia
CHF
Antiadrogenic

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28
Q

Names: ENaC inhibitors

A

Amiloride

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29
Q

Indications: ENaC inhibitors

A

Hypokalemia caused by other drugs
Nephrogenic DI
Liddle’s syndrome

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30
Q

Names: SGLT2 antagonists

A

Canaglifozin

Dapaglifozin

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31
Q

ADH agonists

A

Desmopressin

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32
Q

MOA: Desmopressin

A

Synth. analoge of ADH
V2 selective agonist
CAn be given in many ways

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33
Q

Indications: Desmopressin

A

Centrala DI

Nocturia

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34
Q

ADH antagonists:

A

Tolvaptan

Conivaptan

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35
Q

MOA: Tolvaptan

A

Selective V2 antagonist

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36
Q

Diuretics used in HTN:

A

Thiazides- Hydrochlorothiazide

Loop diuretics- Furosemide

37
Q

Which has 2-3 h duration of action?

Hydrochlorothiazide/Furosemide

A

Furosemide

38
Q

Which has longer duration of action?

Hydrochlorothiazide/Furosemide

A

Hydrochlorothiazide: 8-12H

39
Q

Sympatholytics used in HTN:

A
Clonidine- a2 agonist
Methyldopa- a2 agonist
Prazosin- a1 antag
Doxazosin- a1 antag
Tamsulosin- a1 antag
Proprapranol- B non selective
Metoprolol- B1 selective
Bisoprolol- B1 selective
Nevibolol- B1 selective
Labetalol- a.B
Carvedilol- a,B
40
Q

Which B non selective can enter thr CNS?

A

Propranolol

41
Q

Dihydropyridines, which is long acting?

A

Amlodipine

42
Q

Dihydropyridines, which is short acting?

A

Nifedipine

43
Q

Dihydropyridines:

A

Nifedipine
Amlodipine
Nicardipine
Nimodipine

44
Q

Which Dihydropyridine can help treat subarachnoid hemorrhage?

A

Nimodipine

45
Q

Indications: Diltiazem

A

HTN

Angina pectoris

46
Q

Which c be given to pregnant women?

A

Nifedipine

47
Q

Indications: Verapamil

A

HTN
Angina pectoris
Migrane prophylaxis
Anti arrhytmic

48
Q

Which class AA is Verapamil?

A

Class IV

49
Q

Which Dihydropyridine can exacerbate Myocardial ischemia?

A

Nifedipine

50
Q

CCB contraindications

A

Conduction abnormalities

CHF patients

51
Q

HTN ttreatment: NO releasing agents

A

Hydralazine

Nitroprusside

52
Q

Which drug induce the release of NO from endothelial cells?

A

Hydralazine

53
Q

Adverse effect: Hydralazine

A

Lupus at high dose

54
Q

Which NO releasing drug induces arterial and venous dilation?

A

Nitroprusside

55
Q

Adverse effect: Nitroprusside

A

Cyanide toxicity

56
Q

Nitroprusside is Long/Short acting

A

Short

57
Q

K+ channel opening agents

A

Minoxidil

Diazoxine

58
Q

Indications: Minoxidil

A

Severe HTN

Baldness (topical)

59
Q

Fenoldopam has short/long duration

A

Short- 10 min

60
Q

Endothelin antagonist:

A

Bosentan

61
Q

ACE inhibitors:

A

Captopril
Enalapril
Perindopril
Ramipril

62
Q

Which is not a prodrug?

Captopril
Enalapril
Perindopril
Ramipril

A

Captopril

כי הוא ילד כאפות

63
Q

MOA: ACE inhib.

A

Reduction of AG-II and Aldosterone

Increase in bradykinin- Vasodilator

64
Q

Adverse effects: ACE inhib.

A

Dry cough
Teratogen
Hyperkalemia
AKI

65
Q

ARB’s:

A

Losartan
Irbesartan
Valsartan

66
Q

ARB’s adverse effect

A

Teratogenic

Hyperkalemia

67
Q

Aliskiren is a

A

Renin antagonist

68
Q

Adverse effect: Aliskiren

A

Teratogenic
Hyperkalemia
Angioedema

69
Q

Indication of drug therapy for HTN

A

BP > 140/90 mmHg

70
Q

Anti hypertensive therapy- How will you start?

A
ACE inhib. or ARB's + CCB or diuretics
if resistance
ACE inhib. or ARB's + CCB + diuretics
if resistance
Add Spironolactone and B blocker
71
Q

Spironolactone is an example of _____ drug

A

K+ sparing diuretics- Aldosteron receptor inhibitor

72
Q

Nitrates

A

Nitroglycerin

Isosobride dinitrate

73
Q

Adverse effect: Nitrates

A
Headaches
Flushing
Reflex tachycardia
Tolerance after 8-10 h
Syncope
74
Q

Contraindications: Nitrates

A

Systolic BP < 90 mmHg
Right vent. MI
Patient on PDE-5 inhib.
HOCM

75
Q

Which B non selective antag. can be given in case of Angina?

A

Propranolol

76
Q

New drugs for the treatment of Angina

A

Trimetazidine

Ivabradine

77
Q

MOA: Trimetazidine

A

pFOX inhibitor

78
Q

Druga that improve survival in HF patients

A

ACE inhib.
ARB’s
Spironolactone
B-Blockers

79
Q

Diuretics that are given in case of CHF

A

Hydrochlorothiazide
Furosemida
Spironolactone

80
Q

Drugs that increase cardiac muscle contractility

A

Digoxin
B-agonists
PDE-III inhib.

81
Q

Digoxin is eliminated by

A

Kidnys

82
Q

Net effects: Digoxin

A
Positive ionotropic (Increased I.C Ca2+)
Negative chronotropic (Vagus stimulation)
Negative dromotropic (AV decreased)
83
Q

Contraindications: Digoxin

A

Hypertrophic cardiomyopathy
WPW
AV block
Diastolic HF

84
Q

Digitoxin is eliminates by the

A

Liver

85
Q

B Blockers that are given in the treatment of HF

A

Metoprolol (B1 selective)

Carvedilol (B,a)

86
Q

PDE in the treatment of Acute HF

A

Milrinone

Theophylline

87
Q

Contraindication agents in CHF

A

Thiazolinedione
NSAID’s
COX-2 inhib.
CCB

88
Q

Which drug is completely contraindicated in acute HF?

A

B-Blockers