Intro to Antihypertensive Agents II Flashcards Preview

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Flashcards in Intro to Antihypertensive Agents II Deck (50):
1

acetazolamide

carbonic anhydrase inhibitor

2

brinzolamide

carbonic anhydrase inhibitor

3

dorzolamide

carbonic anhydrase inhibitor

4

methazolamide

carbonic anhydrase inhibitor

5

furosemide

loop diuretic

lasix

6

ethacrynic acid

loop diuretic
-will not cause sulfa allergy**

7

bumetanidine

loop diuretic

8

torsemide

loop diuretic

9

HCTZ

thiazide diuretic

10

chlorothiazide

thiazide diuretic

11

hydroflumethiazide

thiazide diuretic

12

indapamide

thiazide diuretic

13

methylclothiazide

thiazide diuretic

14

metolazone

thiazide diuretic

15

polythiazide

thiazide diuretic

16

trichlormethiazide

thiazide diuretic

17

eplerenone

K sparing
-aldosterone antagonist

18

spironolactone

K sparing
-aldosterone antagonist

19

amiloride

K sparing
-ENaC inhibitor

20

triamterene

K sparing
-ENaC inhibitor

21

mannitol

aquaretic
-osmotic diuretic

22

isosorbide

aquaretic
-osmotic diuretic

23

conivaptan

aquaretic
-ADH antagonist

24

tolvaptan

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