Pharmacology

Question 1

What is oedema?

Answer 1

An imbalance between formation and absorption of interstitial fluid.

Question 2

An increase in what pressure causes oedema?

Answer 2

Capillary hydrostatic pressure

Question 3

A decrease in what can cause the formation of interstitial fluid?

Answer 3

Protein

Question 4

What is nephrotic syndrome?

Answer 4

Glomerular filtration issue which allows protein in filtrate and therefore proteinuria.

Question 5

If interstitial fluid collects, what does this do the blood volume?

Answer 5

Decreases it.

Question 6

If blood volume is low, how is this corrected?

Answer 6

RAAS system activated

Question 7

What does proteinuria look like?

Answer 7

Frothy

Question 8

How does CHF cause oedema?

Answer 8

Reduced CO causes renal hypo perfusion which activates RAAS.
Increased capillary pressure leads to oedema.

Question 9

How does hepatic cirrhosis with ascites cause oedema?

Answer 9

Increased pressure in hepatic portal vein and less albumin causes movement of fluid into peritoneum.
RAAS system activated.

Question 10

Which diuretic works on TAL of loop of Henle?

Answer 10

Loop diuretics

Question 11

Which diuretic works on DCT?

Answer 11

Thiazide diuretic

Question 12

Where does potassium sparing diuretics work on?

Answer 12

Collecting tubule

Question 13

At which membrane do diuretics work on?

Answer 13

Apical membrane on tubular cells

Question 14

Which diuretic are acidic?

Answer 14

Thiazides and loop diuretics

Question 15

Which transport systems work with acidic drugs?

Answer 15

Organic anion transporters (OAT)

Question 16

What kind of substance is the anion swapped for at the basolateral membrane?

Answer 16

Ketone.

alpha- ketoglutarate.

Question 17

What transporter do loop diuretics work on?

Answer 17

Triple transporter

Na+/K+/2Cl-

Question 18

How do loop diuretics work?

Answer 18

Blocks triple transporter so sodium is retained in tubular lumen and gets peed out. Water follows sodium

Question 19

Give an example of a loop diuretic

Answer 19

Furosemide

Question 20

When would loop diuretics be used?

Answer 20

Acute pulmonary oedema
Chronic Heart failure
Ascites
HTN
Chronic kidney failure

Question 21

What are the adverse effects of loop diuretics?

Answer 21

Potassium loss
Metabolic alkalosis
Hypovolaemia
Increased plasma uric acid

Question 22

How do thiazide diuretics work?

Answer 22

Block the Na+/Cl- co-transporter in DCT

Question 23

Give an example of a thiazide diuretic

Answer 23

Bendroflumethiazide

Question 24

Where are thiazide diuretics used?

Answer 24

Mild heart failure
HTN
Resistant oedema
Nephrolithasis

Question 25

Give an example of potassium sparing diuretics

Answer 25

Spironolactone.

Question 26

How does spironolactone work?

Answer 26

Competes with aldosterone for binding to Na+/KATPase pumps

Question 27

When are potassium sparing diuretics used?

Answer 27

In conjunction with agents that cause hypokalaemia or will cause HYPERkalaemia

Question 28

Where do osmotic diuretics work?

Answer 28

PCT.

Question 29

How do osmotic diuretics enter the renal system?

Answer 29

Glomerular filtration

Question 30

Give an example of an osmotic diuretic

Answer 30

Mannitol

Question 31

What effect does aldosterone have on Na+?

Answer 31

Na+ reabsorption to blood

Question 32

What effect does aldosterone have on K+?

Answer 32

Secretion of K+

Question 33

What effect does vasopressin have on water?

Answer 33

Increases water reabsorption

Question 34

What are vaptans?

Answer 34

Competitive antagonists of vasopressin receptors

Question 35

What effect do vaptans have on water?

Answer 35

Block V2 receptors which causes excretion of water.

Question 36

What effect do vaptans have on sodium?

Answer 36

Do not change sodium levels but increase the concentration

Question 37

What vaptans are available for use?

Answer 37

Conivaptan | Tolvaptan

Question 38

When are vaptans used?

Answer 38

SIADH

Question 39

What do SGLT2 co-transporters do?

Answer 39

Allow renal reabsorption of glucose in PCT

Question 40

Where are SGLT1 cotranporters?

Answer 40

Intestine

Question 41

How do SGLT2 cotransporters work?

Answer 41

Na+:glucose against a concentration gradient

Question 42

What must a clinician remember when doing a urinalysis on a patient on SGLT2 inhibitor?

Answer 42

Glucosuria present

Question 43

Name an SGLT2 inhibitor

Answer 43

Dapagliflozin

Question 44

Why might SGLT2 inhibitors cause weight loss?

Answer 44

Calorific loss of glucose

Question 45

What is a side effect of SGLT2 inhibitors?

Answer 45

Increased UTIs

Question 46

Which prostaglandin affects the medulla?

Answer 46

PGE2

Question 47

What do prostaglandins do?

Answer 47

Vasodilation, prevent sodium loss.

Question 48

When are prostaglandins increased?

Answer 48

Trauma Ischaemia Bradykinin

Question 49

What part of the kidney do prostaglandins affect?

Answer 49

Vasodilation of afferent arteriole

Question 50

What hormone does prostaglandin release?

Answer 50

Renin from granular cells of juxtaglomerular apparatus

Question 51

Which drugs inhibit prostaglandins?

Answer 51

NSAIDs

Question 52

What effect will NSAIDs have in those with renal dysfunction?

Answer 52

Will cause acute renal failure and decrease GFR