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CVPR > CV - diuretics and RAAS antagonists > Flashcards

CV - diuretics and RAAS antagonists Flashcards

1
Q

specific goals of heart failure management with pharmacology

A

reduction of congestion
modulation of neurohormonal activation
improve flow

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2
Q

what is the primary class of drugs involved in reduction of congestion?

A

diuretics

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3
Q

what are the primary classes of drugs involved in modulation of neurohormonal activation?

A

RAAS antagonists

beta-blockers

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4
Q

what is the primary class of drugs involved in improvement of flow?

A

vasodilators

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5
Q

what is the most common loop diuretic?

A

furosemide

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6
Q

name five additional diuretic agents

A 
hydrochlorothiazide
spironolactone
mannitol
torsemide
bumetanide
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7
Q

what must be monitored when using aldosterone antagonists?

A

serum K+

pH

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8
Q

diuretics interfere with __________ reabsorption, thus decreasing the amount of __________ that is absorbed and resolving the __________.

A

Na+
water
edema

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9
Q

what is the mechanism of action of thiazides and furosemide?

A

interactions with membrane transport proteins

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10
Q

what is the mechanism of spironolactone?

A

interactions with hormone receptors

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11
Q

what is the mechanism of mannitol?

A

osmotic effects preventing water reabsorption

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12
Q

a decrease in __________ reabsorption means more __________ at the __________, ultimately resulting in more __________ and __________ loss and leading to __________.

A 
Na+
Na+
collecting tubule
H+
K+
hypokalemic metabolic alkalosis
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13
Q

you reabsorb most Na+ in the __________.

A

proximal convoluted tubule

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14
Q

name the three loop diuretics with which we are concerned

A

furosemide
bumetanide
torsemide

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15
Q

thiazides and loop diuretics are secreted into the __________ from the __________ and use the same transporter as __________, thus preventing __________ from being transported and leading to __________.

A 
urine
blood
uric acid
uric acid
hyperuricemia
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16
Q

all of the loop diuretics are __________ derivatives except __________.

A

sulfonamide

ethacrynic acid

17
Q

__________ can be used if sulfonamide allergy.

A

ethacrynic acid

18
Q

what are the most significant adverse affects of loop diuretics?

A

hypokalemic metabolic alkalosis

hyperuricemia

19
Q

thiazide diuretics inhibit the __________ cotransporter.

A

Na+/Cl-

20
Q

thiazides increase reabsorption of __________, unlike loop diuretics which decrease serum __________ levels.

A

Ca++

21
Q

a decrease in __________ reabsorption means more __________ at the collecting tubule, ultimately resulting in more __________ and __________ loss, leading to __________.

A 
Na+
Na+
K+
H+
hypokalemic metabolic alkalosis
22
Q

name two thiazide diuretic agents

A

hydrochlorothiazide

chlorthalidone

23
Q

thiazide diuretics are secreted by the organic acid secretory system, thus competing with __________ secretion and increasing the risk of __________.

A

uric acid

gout attack

24
Q

what are the adverse reactions associated with thiazide diuretics?

A

hypokalemia
predisposition to ectopic pacemakers
hyperglycemia
gout

25
Q

what are the two classes of potassium-sparing diuretic agents, and which are used in heart failure?

A

aldosterone receptor antagonists
collecting tubule sodium channel blockers

aldosterone antagonists are used in heart failure

26
Q

aldosterone antagonists are used in heart failure, primarily due to their __________ actions via block of __________ receptors.

A

cardiac anti-remodeling actions

cardiac aldosterone receptors

27
Q

name two K+-sparing diuretics

A

spironolactone

eplerenone - not an aldosterone antagonist

28
Q

what are the adverse reactions associated with aldosterone antagonist K+-sparing diuretics?

A

hyperkalemia

gynecomastia

29
Q

name the aldosterone antagonist K+-sparing diuretic we need to know

A

spironolactone

30
Q

beta-blockers improve cardiac function in heart failure by __________.

A

cardiac anti-remodeling effects

31
Q

a male patient is placed on a new medication for heart failure and notes that his breasts have become tender to the touch. which medication is he most likely taking?

A

spironolactone

32
Q

once renal function is below 50%, you begin to loose efficacy in all diuretic classes except __________.

A

loop diuretics

33
Q

what does the “pril” suffix denote?

A

RAAS antagonists - ACE inhibitors

CVPR (14 decks)

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