Katzung: Diuretics

Question 1

Drug that increases sodium bicarbonate excretion thus creating hyperchloremic metabolic acidosis

Answer 1

carbonic anhydrase inhibitor

Question 2

Hypokalemic metabolic alkalosis produced by

Answer 2

Loop and Thiazide diuretics

Question 3

Acetazolamide reduces secretion of aqueous humor thus treating and aso induces metabolic acidosis thus increasing respiration and treating

Answer 3

open angle glaucoma

mountain sickness

Question 4

Topical applications of carbonic anhydrase inhibitors

Answer 4

Dorzolamide, brinzolamide

because ciliary body secretes HCO3 into the aqueous humor and inhibition of CA means less aqueous humor prodn

Question 5

A patient with cirrhosis who is on a carbonic anhydrase inhibitor could develop hyper______

Answer 5

hyperammonemia

Question 6

Calcium phosphate stones are less soluble at _______ pH

Answer 6

alkaline. This means carbonic anhydrase inhibitors can promote production of renal stones

Question 7

Loop diuretics are ________ which can cause allergy, _________ acid can be used as a substitute

Answer 7

loops are sulfonamides; use ethacrynic acid instead

Question 8

Loops block the NKCC pump in the apical surface of the thick ascending LOH

Answer 8

Furosemide
Bumetanide
Torsemide
Ethacrynic Acid

Question 9

Loop adverse effects

Answer 9

Increased delivery of Na to the DCT means more Na reabsorbed which promotes K secretion leading to hypokalemia

No calcium disturbances because calcium is reabsorbed actively in the DCT under PTH control

Increase in Magnesium excretion because of decreased K+ luminally, so hypomagnesemia

Question 10

Loops are powerful stimulators of renin release because

Answer 10

reduced NaCl reabsorption and more sodium in the tubular fluid which leads to decreased sodium influx into the macula densa which leads to increased prostaglandin release and increased renin secretion

Question 11

Loops are most commonly used for

Answer 11

pulmonary edema

Question 12

Loops are also used for

Answer 12

htn if thiazides don’t work

Severe hyperkalemia

Acute Renal Failure to convert oliguric to nonoliguric failure

Question 13

Loop diuretic adverse effects

Answer 13

metabolic hypokalemic alkalosis
ototoxicity (ethacrynic acid)
Hypovolemia and consequent hyperuricemia/gout attacks
Efficacy reduced by NSAIDs
Sulfonamide alx

Question 14

Digitalis toxicity is facilitated by hypokalemia making what diuretic agents dangerous in those patients on digoxin?

Answer 14

Loop diuretics

Thiazides

Question 15

Potassium sparing diuretics used in patients on digoxin get around the potential for hypokalemic induced toxicity but can cause what imbalance leading to arrhythmias

Answer 15

Hyperkalemia

Question 16

thiazides inhibit what channel?

Answer 16

The sodium chloride transport in the early segment of the distal convoluted tubule

Question 17

Thiazides, have a ______ DOA

Answer 17

6-12 hours

Question 18

What sort of alkalosis can ensue when on thiazides

Answer 18

Hypokalemic metabolic alkalosis

Question 19

What are some thiazide-like drugs

Answer 19

Chlorthalidone

longer acting than HCTZ

Question 20

Thiazides are used to treat

Answer 20

htn in African Americans
Mild Heart Failure
Hypercalciuria w/ stones
Nephrogenic Diabetes Insipidus