Intro to Antihypertensive Agents II Flashcards
1
Q
acetazolamide
A
carbonic anhydrase inhibitor
2
Q
brinzolamide
A
carbonic anhydrase inhibitor
3
Q
dorzolamide
A
carbonic anhydrase inhibitor
4
Q
methazolamide
A
carbonic anhydrase inhibitor
5
Q
furosemide
A
loop diuretic
lasix
6
Q
ethacrynic acid
A
loop diuretic
-will not cause sulfa allergy**
7
Q
bumetanidine
A
loop diuretic
8
Q
torsemide
A
loop diuretic
9
Q
HCTZ
A
thiazide diuretic
10
Q
chlorothiazide
A
thiazide diuretic
11
Q
hydroflumethiazide
A
thiazide diuretic
12
Q
indapamide
A
thiazide diuretic
13
Q
methylclothiazide
A
thiazide diuretic
14
Q
metolazone
A
thiazide diuretic
15
Q
polythiazide
A
thiazide diuretic
16
Q
trichlormethiazide
A
thiazide diuretic
17
Q
eplerenone
A
K sparing
-aldosterone antagonist
18
Q
spironolactone
A
K sparing
-aldosterone antagonist
19
Q
amiloride
A
K sparing
-ENaC inhibitor
20
Q
triamterene
A
K sparing
-ENaC inhibitor
21
Q
mannitol
A
aquaretic
-osmotic diuretic
22
Q
isosorbide
A
aquaretic
-osmotic diuretic
23
Q
conivaptan
A
aquaretic
-ADH antagonist
24
Q
tolvaptan
A
aquaretic
-ADH antagonist
25
carbonic anhydrase inhibitors
- proximal convoluted tubule
- membrane bound and cytoplasmic forms of enzyme
-result in decreased H formation in cell
> decreased Na/H antiport
> increased Na and HCO3 in lumen
> increased diuresis
**urine pH increase and body pH decrease**
**hypokalemia, but metabolic acidosis**
26
indications for CAIs
rarely used - develop metabolic acidosis
-glaucoma, acute mountain sickness, metabolic alkalosis
27
adverse effects of CAIs
- acidosis
- hypokalemia
- renal stones
- paresthesias
- sulfonanide hypersensitivity
28
loop diuretics
-inhibit lumen Na/K/2Cl cotransporter in thick ascending limb
-increased lumen Na, K and Cl
>decreased back diffuse of K and positive potential in lumen
>decreased reabsorption of Ca and Mg
>diuresis
among most efficacious diuretics**
good for edematous states
29
loop diuretic activity
tied to secretion rate
-half life correlates to kidney function
- 0.5-2 hours (healthy)
- 9 hours (ESRD)
30
adverse effects of loop diuretics
hypokalemia, alkalosis, hypocalcemia, hypomagnesemia, hyperuricemia, ototoxicity, sulfonamide hypersensitivity (not all)
31
thiazide diuretics
inhibits Na/Cl cotransport and block Na/Cl reabsorption in distal convoluted tubule
-increased lumen Na and Cl in DCT
> diuresis
-increased reabsorption of Ca in PCT
>due to volume contraction
**indicated for kidney stones (like loop diuretics)
32
uses for thiazide diuretics
HTN, mild heart failure, nephrolithiasis, nephrogenic diabetes insipidus
33
side effects of hyperglycemia and hyperlipidemia
thiazide diuretics
caution in diabetic patients
34
adverse effects of thiazide diuretics
hypokalemia, alkalosis, hypercalcemia*, hyperuricemia, hyperglycemia, hyperlipidemia*, sulfonamide hypersensitivity
*caution with diabetics
35
mechanisms of K sparing diuretics
- mineralocorticoid receptor antagonists
- ENaC inhibitors
both decrease ENaC at luminal membrane
>no Na reabsorption at collecting tubule
>no loss of potassium
**no hypokalemia
**add this to stop hypokalemia with other drugs
36
mineralocorticoid receptor antagonists
inhibit aldosterone
>decreased ENaC in principal cells of collecting duct
>diuresis
**don't require access to tubular lumen
37
clinical for K sparing diuretics (MR antagonists)
hyperaldosteronism, antiandrogenic use, heart failure
38
clinical for K sparing diuretics (ENaC (-))
adjunct for K-wasting diuretics, lithium induced nephrogenic diabetes insipidus
39
adverse effects for K sparing diuretics (MR antagonists)
hyperkalemia, acidosis, antiandrogenic effects
40
adverse effects of K sparing diuretics (ENaC inhibitors)
hyperkalemia and acidosis
41
mineralocorticoid receptor
nuclear hormone receptor
-natural agonist is mineralocorticoids influence salt and water balance
ex agonists/ aldosterone, deoxycorticosterone, cortisol
aka aldosterone receptor
42
CAIs and pH
decreased body pH
43
loop diuretics and pH
increased body pH
44
loop agent plus thiazides and pH
increased body pH
45
K sparing diuretics and pH
decrease body pH
46
all diuretics
increased NaCl in urine
47
diuretics and HCO3
CAIs have largest urinary HCO3
| -therefore acidosis occurs
48
all diuretics except K sparing
increased K in urine
| -hypokalemia
49
CAIs and K sparing diuretics
decreased body pH
50
loop agents, thiazides, loop agents plus thiazides
increased body pH
