CV - diuretics and RAAS antagonists

Question 1

specific goals of heart failure management with pharmacology

Answer 1

reduction of congestion
modulation of neurohormonal activation
improve flow

Question 2

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

Answer 2

diuretics

Question 3

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

Answer 3

RAAS antagonists

beta-blockers

Question 4

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

Answer 4

vasodilators

Question 5

what is the most common loop diuretic?

Answer 5

furosemide

Question 6

name five additional diuretic agents

Answer 6

hydrochlorothiazide
spironolactone
mannitol
torsemide
bumetanide

Question 7

what must be monitored when using aldosterone antagonists?

Answer 7

serum K+

pH

Question 8

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

Answer 8

Na+
water
edema

Question 9

what is the mechanism of action of thiazides and furosemide?

Answer 9

interactions with membrane transport proteins

Question 10

what is the mechanism of spironolactone?

Answer 10

interactions with hormone receptors

Question 11

what is the mechanism of mannitol?

Answer 11

osmotic effects preventing water reabsorption

Question 12

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

Answer 12

Na+
Na+
collecting tubule
H+
K+
hypokalemic metabolic alkalosis

Question 13

you reabsorb most Na+ in the __________.

Answer 13

proximal convoluted tubule

Question 14

name the three loop diuretics with which we are concerned

Answer 14

furosemide
bumetanide
torsemide

Question 15

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

Answer 15

urine
blood
uric acid
uric acid
hyperuricemia

Question 16

all of the loop diuretics are __________ derivatives except __________.

Answer 16

sulfonamide

ethacrynic acid

Question 17

__________ can be used if sulfonamide allergy.

Answer 17

ethacrynic acid

Question 18

what are the most significant adverse affects of loop diuretics?

Answer 18

hypokalemic metabolic alkalosis

hyperuricemia

Question 19

thiazide diuretics inhibit the __________ cotransporter.

Answer 19

Na+/Cl-

Question 20

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

Answer 20

Ca++

Question 21

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

Answer 21

Na+
Na+
K+
H+
hypokalemic metabolic alkalosis

Question 22

name two thiazide diuretic agents

Answer 22

hydrochlorothiazide

chlorthalidone

Question 23

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

Answer 23

uric acid

gout attack

Question 24

what are the adverse reactions associated with thiazide diuretics?

Answer 24

hypokalemia
predisposition to ectopic pacemakers
hyperglycemia
gout

Question 25

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

Answer 25

aldosterone receptor antagonists collecting tubule sodium channel blockers aldosterone antagonists are used in heart failure

Question 26

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

Answer 26

cardiac anti-remodeling actions | cardiac aldosterone receptors

Question 27

name two K+-sparing diuretics

Answer 27

spironolactone | eplerenone - not an aldosterone antagonist

Question 28

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

Answer 28

hyperkalemia | gynecomastia

Question 29

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

Answer 29

spironolactone

Question 30

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

Answer 30

cardiac anti-remodeling effects

Question 31

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?

Answer 31

spironolactone

Question 32

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

Answer 32

loop diuretics

Question 33

what does the "pril" suffix denote?

Answer 33

RAAS antagonists - ACE inhibitors