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Pharmacology & Drugs > Renal- Diuretics > Flashcards

Renal- Diuretics Flashcards

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1
Q

What are the clinical applications for amiloride

A

Counteracts the potassium loss of other diuretics during edema or hypertension

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2
Q

What is the effect of the potassium sparing diuretics on the levels of bicarbonate loss

A

Significant bicarbonate loss by interfering with the distal H+ secretion

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3
Q

At what location do sodium channel blockers work

A

Cortical collecting duct

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4
Q

What class of drug is metolazone

A

Thiazide diuretics

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5
Q

At what location do thiazide diuretics work

A

Distal convoluted tubule

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6
Q

What class of drug is acetazolamide

A

Carbonic anhydrase inhibitor

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7
Q

IN the case of cardiac failure, where digitalis is used, what drugs must also be monitored and what is the reason

A

-Potassium losing diuretics because hypokalemia increases the toxicity of digitalis, so the levels of potassium must be watched

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8
Q

What class of drug is hydrochlorothizide

A

Thiazide diuretics

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9
Q

What are the adverse effects of carbonic anhydrase inhibitors

A

Hyperchloemic metabolic acidosis
Renal stones:nephrolithiasis
Potassium wasting

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10
Q

What class of drug is torsemide

A

Loop diuretic

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11
Q

What is the mechanism of action for eplerenone

A

Blocks aldosterone from being able to bind to its receptor, meaning that more sodium is excreted and more potassium reuptaken

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12
Q

At what location do loop diuretics work

A

Thick ascending loop of Henle

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13
Q

What class of drug is spironolactone

A

Aldosterone blocking, potassium sparing diuretic

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14
Q

What class of drug is furosemide

A

Loop diuretic

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15
Q

What is the class of drug for triamterene

A

Sodium channel blocker, potassium sparing diuretic

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16
Q

What is the condition of the urine with a loop diuretic

A

Isotonic urine

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17
Q

What are the urine effects of giving a loop diuretic

A

-Loss of water, sodium, potassium, chloride, magnesium, and calcium

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18
Q

What is the clinical applications of aldosterone blocker, potassium sparing diuretics

A

Counteracts potassium loss of other diuretics usually used with hypertension and edema.

  • Reduced fibrosis in post-MI heart failure
  • Primary hyperaldosteronism
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19
Q

At what location do osmotic diuretics work

A

Proximal tubule

Thin descending limb of Henle

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20
Q

What is the relation of the loop diuretics with regards to their benefits

A

Torsemide-Longer half life, works better in heart failure
Bumetanide-more predicatable Oral Absorption
Ethacrynic acid- Used in sulfa allergies

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21
Q

How do thiazides decrease the risk of kidney stones

A

Decreases the calcium excretion (as opposed to the loop diuretics) because more is absorbed in the proximal tubules due to volume contraction

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22
Q

What is the result of action potentials during hyperkalemia

A

Depolarizers membranes and increases firing

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23
Q

What is the treatment for nephrogenic diabetes insipidus if the cause is not lithium

A

Thiazides

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24
Q

What are the toxicities assocaited with loop diuretics

A

Low levels of:Mg, Cl, Na, K, Ca

  • Hypochloremic metabolic alkalosis
  • Hyperglycemia
  • Hyperuricemia
  • ototoxicity
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25
What is the mechanism of action in thiazides
Blocks the sodium calcium transporter in the distal convoluted tubule
26
What is the mechanism of action for spironolactone
Blocks aldosterone from being able to bind to its receptor, meaning that more sodium is excreted and more potassium reuptaken
27
What class of drug is chlorthalidone
Thiazide diuretics
28
What must be considered in the use of torsemide
Sulfa drug, so watch for allergies
29
What are the main toxicities of the sodium blocker, potassium sparing diuretics
- Hyperkalemia (main one) - Hyponatremia - hyper chloremic metabolic acidosis
30
What is the mechanism of action for Triamterene
Blocks the luminal ENaC channels in the collecting ducts, which decreases reuptake of sodium and increases the amount in urine, while decreasing the amount of potassium loss
31
What are the therapeutic uses
-Prophylaxis of renal failure (keeps water in the tubules)-Reduction in intracranial and intraocular pressures
32
What is the mechanism of action of the thiazides
Sodium/Chloride cotransporter blocker in the distal convoluted tubule
33
What is a major side effect of furosemide with regards to organ systems
Causes ototoxicities
34
At what location do the aquaretics known as -Vaptans work
Collecting duct
35
What are the effects of hypokalemia on the heart
- Flattened T waves - Tall U waves - Prolonged QT
36
What is a serious side effect on a different receptor in the use of aldosterone blocker diuretics
Partial agonist at androgen receptors
37
What are the clinical applications of using a loop diuretic
Edema from CHF To decrease ECF volume Hypertension
38
What class of drug is amiloride
Sodium channel blocker, potassium sparing diuretic
39
What class of drug is mannitol
Osmotic diuretic
40
What class of drug is ethacrynic acid
Loop diuretic
41
What is the mechanism of action for the aquaretics known as the -Vamptans
Block the ADH receptor in the collecting duct, so there is more water excreted
42
What class of drug is spironolactone
Aldosterone antagonist, potassium sparing diuretic
43
What are the toxicities of using aldosterone blocking potassium sparing diuretics
Hyperkalemia | -amenorrhea, hirtutism, hynocomastia, impotence, tumorgenic
44
At what location do carbonic anhydrase inhibators work
Proximal Tubule
45
How do loop diuretics lead to a loss of magnesium and calcium
Potassium is not allowed to leak back in, which normally pulls calcium and magnesium in with it.
46
What are the clinical applications for thiazides
- Hypertension (does not work if there is low GFR) - Edema - Calcium nephrolithiasis - Nephrogenic diabetes insipidus
47
What are the adverse effects of mannitol
-ECF is increased because it pulls water our of the cells, with fluid and electrolyte imbalanced
48
What is a main thing hydrochlorothiazide is used to treat
Nephrogenic diabetes insipidus
49
What are the effects of using a thiazide
Increases the urinary excretion of: | -Water, sodium, potassium, and magnesium
50
What is a diuretic
Promotes excretion of urine
51
What must be considered in the use of butetanide
Sulfa drug, so watch for allergies
52
What is the mechanism of action for amiloride
Blocks the luminal ENaC channels in the collecting ducts, which decreases reuptake of sodium and increases the amount in urine, while decreasing the amount of potassium lost
53
What are the toxicities associated with thiazides
Low levels of:K, Mg, Na, Cl -Hypochloremic metabolic alkalosis Hyperglycemia, hypercalcemia, hyperuricemia
54
What are the pharmacokinetics of aldosterone blocker potassium sparing diuretics
Because not directly blocking receptors, can take 24 hours to take effect
55
What is a aquaretic
Substance that produces free water clearance
56
At what location does spironolactone work
Cortical collecting duct
57
What are the toxicities of the -Vamptans
Orthostatic hypotension Thirst Fatal hepatotoxicitiy
58
What is a crucial aspect to loop diuretics with regards to patients with hypertension
Given when others have failed because can be used in cases where RBF and GFR are low
59
What class of drug is triamterene
Sodium channel blocking potassium sparing diuretic
60
What is the mechanism of action for the conivaptan
Non-peptide arginine vasopressin receptor antagonist
61
What is the clinical application of triamterene
Counteracts the potassium loss of other diuretics during edema or hypertension
62
What is the treatment for nephrogenic diabetes insipidus if the cause is lithium
Amiloride (blocks the influx of lithium into the CCD cells)
63
What is the effect seen if someone ingests too much real licorice
Contains glycyrrhizic acid, with can potential aldosterone effects and lead to kidney and increases in systolic blood pressure
64
What must be considered in the use of furosemide
A sulfa drug, so watch for allergies
65
What is the result of action potentials in the case of hypokalemia
Hyperpolarizes the membranes and decreases firing
66
What are the clinical applications of conivaptan and tolvaptan
Treatment of hypervolemia and euvolemia in patients who are hyponatremic (only in those who are in the hospital so they can be closely monitored) -Can slow progression of adult polycystic kidney disease
67
What is a natriuretic
Substance that promotes the renal excretion of sodium
68
What drug interactions must be avoided with the use of aldosterone blocking potassium sparing diuretic
Drugs that increase plasma potassium levels or ACE inhibitors
69
What class of drug is conivaptan
Auaretics
70
What are the pharmacokinetics of the -vamptans
Product of CYP3A4, so must be watched with the inducers or inhibitors of it
71
What is the mechanism of the loop diuretics
Sodium/potassium/chloride co transporter blocker in the loop of Henle (ascending thick)
72
What is the mechanism of action for tolvaptan
Selective V2 receptor antagonist administered of organs
73
In the cause of a patient with a sulfa allergy, which loop diuretic must be given
Ethacrynic acid
74
What is a caution when using hydrochlorothiazide in some patients
A sulfa drug, so watch for allergies
75
What class of drug is tolvaptan
Aquaretics
76
What class of drug is amiloride
Sodium channel blocker, potassium sparing diuretic
77
What is the characteristic of urine while used a thiazide
Dilute urine
78
What class of drug is eplerenone
Aldosterone antagonist, potassium sparing diuretic
79
What class of drug is bumetanide
Loop diuretic
80
What are the effects of Hyperkalemia on the heart
``` Tall T waves Prolonged PR Widened QRS Flat P Bradycardia ```

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