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Step 1 Renal-First Aid 2017 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Angiotensin converting enzyme inhibitors

A

Captopril, Enalapril, lisinopril, Ramipril

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2
Q

ACE inhibitor MOA

A

Inhibit ACE decreasing AT II leading to dilation of efferent arteriole which decreases GFR

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3
Q

ACE inhibitor contraindications

A

C1 esterase inhibitor deficiency

Bilateral renal artery stenosis - leads to renal failure

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4
Q

ACE inhibitor side effects

A

Cough, Angioedema, Teratogen, increased Creatinine, Hyperkalemia and Hypotension

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5
Q

Benefit of ACE inhibitor in chronic kidney disease

A

Decreases intraglomerular pressure slowing GBM thickening

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6
Q

ATII receptor blockers

A

Losartan, candesartan, valsartan

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7
Q

ATII receptor blockers MOA

A

Selectively block AT1 receptors

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8
Q

Cause of cough with ACE inhibitors

A

ACE inhibitors prevent breakdown of bradykinins

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9
Q

Benefit of ATII receptor blockers over ACE inhibitors

A

Do not increase bradykinin levels

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10
Q

Indications for ACE inhibitors

A

HTN, HF, proteinuria, diabetic nephropathy

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11
Q

Benefits of ACE inhibitors in heart disease

A

Decrease mortality in HF and prevent unfavorable heart remodeling as a result of chronic HTN

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12
Q

Indications for ATII receptor blockers

A

HTN, HF, proteinuria, CKD with ACE inhibitor intolerance

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13
Q

ATII receptor blockers side effects

A

Hyperkalemia, decreased GFR, HoTN, teratogen

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14
Q

Aliskiren MOA

A

Blocks conversion AT-I to AT-II by blocking renin

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15
Q

Aliskiren indications

A

HTN

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16
Q

Aliskiren side effects

A

Hyperkalemia, decreased GFR, HoTN, angioedema

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17
Q

Aliskiren contraindications

A

In those already taking ACE inhibitors or ARBs

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18
Q

Thiazide diuretics

A

Hydrochlorothiazide, chlorthalidone, metolazone

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19
Q

Thiazide diuretics MOA

A

Inhibit NaCl reabsorption in DCT decreasing diluting capacity of nephron

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20
Q

Thiazide diuretics indications

A

HTN, HF, idiopathic hypercalciuria, nephrogenic diabetes insipidus, osteoporosis

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21
Q

Thiazide diuretics side effects

A

Hypokalemic metabolic alkalosis, hyponatremia, hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia

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22
Q

Thiazide diuretics contraindications

A

Sulfa allergy

23
Q

Potassium sparing diuretics

A

Spironolactone and Eplerenone; Triamterene and Amiloride

24
Q

Spironolactone and Eplerenone MOA

A

Competitive aldosterone receptor antagonists in cortical collecting tubule

25
Q

Triamterene and Amiloride MOA

A

Block Na channels in cortical collecting tubule

26
Q

Potassium sparing diuretics indications

A

Hyperaldosteronism, K depletion, HF, antiandrogen

27
Q

Additional indication for spironolactone

A

Hepatic ascites

28
Q

Additional indication for amiloride

A

Nephrogenic diabetes insipidus

29
Q

Potassium sparing diuretics side effects

A

Hyperkalemia - causes arrhythmias

30
Q

Spironolactone side effects

A

Gynecomastia and antiandrogen effects

31
Q

What may urine electrolyte may increase with all diuretics

A

Urine NaCl - serum NaCl decreases too

32
Q

What may urine electrolyte may increase with thiazide diuretics

A

Potassium - serum K decreases too

33
Q

Mechanism for alkalemia in loop diuretics

A
  1. Volume contraction - increased AT-II increases Na/H+ exchange in PCT increasing HCO3- reabsorption
  2. K loss causes H-K shift K out and H+ into cells
  3. Low K state H+ exchanged for Na - also causes paradoxical aciduria
34
Q

Mechanism for acidemia in carbonic anhydrase inhibitors

A

Decreased HCO3 reabsorption

35
Q

Mechanism for acidemia K-sparing diuretics

A

Aldosterone blockade prevents K and H+ secretion

36
Q

Mechanism for acidemia in hyperkalemia

A

H-K shift moves K in and H+ out of cells

37
Q

Mechanism for increased urine Ca with loop diuretics

A

Decreased paracellular Ca reabsorption causes hypocalcemia

38
Q

Mechanism for decreased urine Ca with thiazide diuretics

A

Enhanced Ca reabsorption

39
Q

Osmotic diuretic which increases tubular fluid osmolarity leading to increased urine flow and used to treat increased ICP/intraocular pressure

A

Mannitol

40
Q

Indications for mannitol

A

Drug overdose and increased ICP/intraocular pressure

41
Q

Mannitol side effects

A

Pulmonary edema, dehydration

42
Q

Mannitol contraindications

A

Anuria and HF

43
Q

Carbonic anhydrase inhibitor

A

Acetazolamide

44
Q

Acetazolamide MOA

A

Causes self limited NaHCO3 diuresis and decreased total body stores of HCO3- stores

45
Q

Acetazolamide indications

A

Glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness, pseudotumor cerebri

46
Q

Acetazolamide side effects

A

Proximal renal tubular acidosis, paresthesias, NH3 toxicity, hypokalemia, sulfa allergy

47
Q

Loop diuretics

A

Furosemide, bumetanide, torsemide

48
Q

Loop diuretics MOA

A

Sulfonamide loop diuretics inhibit Na/K/2Cl of thick ascending limp of loop of Henle preventing concentration of urine

49
Q

Loop diuretics side effects

A

Ototoxicity, Hypokalemia, Hypomagnesemia, Dehydration, Allergy (sulfa), metabolic Alkalosis, Nephritis, Gout

50
Q

Loop diuretics indications

A

Edematous state, HTN, hypercalcemia

51
Q

Non-sulfonamide inhibitor of Na/K/2Cl of thick ascending limb of loop of Henle

A

Ethacrynic acid

52
Q

Ethacrynic acid indications

A

Diuresis of patients allergic to sulfa drugs

53
Q

Ethacrynic acid side effects

A

Same as loop diuretics but more ototoxic

Step 1 Renal-First Aid 2017 (4 decks)

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