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SP18: Pharm MT3 > Diuretics > Flashcards

Diuretics Flashcards

1
Q

T/F: Water will follow Na during resorption/secretion.

A

True

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2
Q

What happens to water if you block Na resorption into the blood?

A

More water will leave in the urine

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3
Q

How will the resorption of less Na effect blood pressure?

A

Less Na resorbed = less H2O resorbed.

If less H2O in the blood -> blood volume decreases

Decrease in blood volume = decrease in blood pressure

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4
Q

T/F: Most of the filtered plasma gets excreted as urine.

A

False

Out of 180 liters only 1.5 is excreted per day

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5
Q

Where do carbonic anhydrase inhibitors act?

A

Proximal convoluted tubule

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6
Q

What is the goal of carbonic anhydrase?

A

To facilitate the shuttling of Na+ from the lumen back into the blood.

(Bicarbonate comes with it as well)

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7
Q

What is the overall effect of CA inhibitors?

A

Inhibits Na+ resorption -> enhances fluid loss -> lowers blood volume/pressure

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8
Q

Where do osmotic diuretics work?

A

Proximal convoluted tubule and proximal straight tubule

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9
Q

____________ diuretics work by increasing the osmolarity of blood and renal filtrate.

A

Osmotic

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10
Q

Mannitol is an example of a ___________ diuretic. It is not well resorbed back into the blood, and thus water will stick with it and not be resorbed.

A

Osmotic

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11
Q

Where do loop diuretics act?

A

Thick ascending limb

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12
Q

T/F: Loop diuretics are most effective in patients with impaired kidney function.

A

True

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13
Q

How do loop diuretics work?

A

Block a transporter that brings Na+, Cl-, and K+ in from the lumen.

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14
Q

What are some possible side effects from loop diuretics?

A

Mg and Ca imbalances

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15
Q

________________ are sulfonamide derivatives, and therefor could cause allergic reactions.

A

Loop diuretics

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16
Q

Where do thiazides diuretics work?

A

Distal convoluted tubule

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17
Q

_________ diuretics inhibit a Na+ Cl- symporter from the lumen to tubular cells.

A

Thiazide

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18
Q

Which two types of diuretics can cause K+ loss and lead to ion imbalances?

A

Thiazides and loop diuretics

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19
Q

Where do K+ sparing diuretics work?

A

Cortical collecting tubule

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20
Q

In what two ways do K+ sparing diuretics work?

A
  1. Na+ channel from lumen into cell

2. Aldosterone receptor antagonist

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21
Q

______________ are used as adjunctive therapy, together with other drugs, in the treatment of hypertension and management of CHF.

A

K+ sparing diuretics

22
Q

T/F: Diuretics make you pee more.

A

True

23
Q

What are the two blood pressure regulatory system?

A

Short term = sympathetic nervous system

Long term = renal system

24
Q

Describe the baroreflex regulation of blood pressure.

A

Baroreceptors send BP info to medulla -> symp nerves adjust to regulate vasoconstriction, heart beat, cardiac output

25
Q

Where are baroreceptors found in the kidney?

A

JG cells

26
Q

What is released from the juxtaglomerular apparatus when blood pressure decreases?

A

Renin

27
Q

What is the role of renin in regulating BP?

A

Renin turns angiotensinogen into angiotensin I

Angiotensin I is then converted into angiotensin II by ACE

28
Q

Where is angiotensinogen secreted?

A

Liver

29
Q

Where is angiotensin I converted to angiotensin II?

A

In the lung capillaries by ACE

30
Q

What are the effects of angiotensin II?

A

Direct and indirect vasoconstriction, sodium resorption and water retention

Long term: can produce structural remodeling

INCREASE BP

31
Q

Which angiotensin II receptor is important for pharm intervention?

A

AT1 receptor (GPCR)

32
Q

T/F: Angiotensin II stimulates aldosterone release.

A

True

33
Q

What are the four classes of drugs used to treat hypertension?

A
  1. Diuretics - reduce blood volume
  2. Sympathoplegic - reduce vascular resistance and CO
  3. Direct vasodilators - relax smooth muscle
  4. Block angiotensin II - reduce vascular resistance and blood volume
34
Q

___________ diuretics are favored for patients with mild to moderate hypertension and normal renal and cardiac function.

A

Thiazide

35
Q

Which type of diuretics are used with more severe hypertension?

A

Loop

36
Q

What is the most common side effect of diuretics for hypertension?

A

K+ depletion

37
Q

What are the three ways sympathoplegic agents work?

A
  1. Act on CNS
  2. Reduce epinephrine release
  3. Block adrenoreceptors

Use diuretics in conjunction to prevent Na retention

38
Q

Sympathoplegic agents that act on the CNS activate _____ receptors, reducing cardiac output.

A

alpha2

39
Q

Sympathoplegic drugs that selectively block adrenoreceptors are aiming to block beta1 receptors having what effect?

A

Diminish CO and renin production

40
Q

What are the four methods that direct vasodilators use to treat hypertension?

A
  1. NO drugs
  2. Reduce Ca+ influx
  3. Hyperpolarize (activate K+ channel)
  4. Activate dopamine
41
Q

What is one of the negative aspects of direct vasodilators?

A

The body senses the changes and tries to compensate

Often have to take more drugs to oppose compensation

42
Q

Which dopamine receptor do some direct vasodilators effect?

A

D1

43
Q

T/F: ACE inhibitors would inhibit angiotensin I production.

A

False

Angiotensin II

44
Q

How do ACE inhibitors promote vasodilation?

A

ACE normally degrades bradykinin which is a vasodilator

Inhibit ACE -> more bradykinin, more vasodilation

45
Q

What class of drugs end in -pril?

A

ACE inhibitors

46
Q

T/F: Lisinopril is a prodrug.

A

False

47
Q

T/F: ACE inhibitors decrease cardiac output and heart rate.

A

False

Decrease peripheral vascular resistance

No effect on heart

Useful if kidney is compromised

48
Q

What class of drugs end in -sartan?

A

Antagonists for angiotensin receptor

49
Q

Angiotensin antagonists bind to _____ receptors.

A

AT1

50
Q

T/F: Angiotensin antagonists affect bradykinin metabolism.

A

False

ACE inhibitors do

SP18: Pharm MT3 (7 decks)

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