Flashcards in Renal Drugs Deck (42):
1
MOA of mannitol
osmotic diuresis
2
uses of mannitol
drug overdose
increased ICP
increased IOP
3
toxicity of mannitol
pulmonary oedema
dehydration
contraindicated in HF and anuria
4
MOA of acetazolamide
inhibits carbonic anhydrase in the PCT
results in self limited NaHCO3 diuresis and decreased total body HCO3- stores.
5
clinical used of acetazolamide
glaucoma
urinary alkalinisation
metabolic alkalosis
altitude sickness
pseudotumor cerebri (chronic vitamin A use)
6
toxicity of acetazolamide
hyperchloremic metabolic acidosis ACIDazolamide causes Acidosis
paresthesias
NH3 toxicity
sulfa allergy
7
list the sulfa drugs
probenecid
furosemide
thiazides
acetazolamide
sulfa abs
sulfonylureas
sulfasalazine
celecoxib
8
list the loops diuretics
furosemide
bumetanide
torsemide
9
MOA of loops
inhibit the NaK2Cl in the thick ascending loop of henle -- no hypertonicity in the medulla -- no concentration of urine
stimulates PGE release - vasodilation of the afferent arterioles (can inhibit with NSAIDs)
Ca excretion
LOOPS LOSE CALCIUM
10
clinical use of loops
edematous states - HG, irrhosis, nephrotic syndrome, pulmonary yoedema
hypertension
hypercalcemia
11
toxicity of loops
OH DANG
ototoxicity
hyperkalemia
dehydration
allergy (sulfa)
nephritis (interstitial)
glout (hyperuricemia)
12
why would you use ethacrynic acid
for diuress in patients allergic to sulfa drugs (furosemide, acetazolamide, thiazides)
13
MOA of ethacrynic acid please
pheonoxyacetic acid derivative with same MOA of forusemide (NaK2Cl blocker)
14
toxicitiy of ethacrynic acid please
similar to furosemide OH DANG: ototoxicity, hyperkalemia, dehydration, neprhritis, gout`
15
list the thiazide diurectic please
chlorthalidone
hhydrochlorothiazide
16
MOA of thiazides
inhibits NaCl reabsorption in early DCT -- decreases diluting ability
decreased Ca excretion
17
clinical use fo thiazides
hypertenision
HF
idiopathic hypercalciuria
nephrogenic diabtes insipidus
osteoporosis
calcium stones
18
toxicity of thiazides
HyperGLUC
hypokalemic metabolic alkalosis
hyponatremia
hyperglycemia
hyperlipidemia
hyperuricemia
hypercalcemia
19
list the K sparing diuretics
spironolactone, eplerenone
triamterene, amiloride
20
MOA of spironolactone and eplerenone
competitive aldoster recetpro antagos in the cortical collecring tubule
21
MOA of triamterene and amiloride
inhibt ENaC in the cortical collecting tubule
22
cx use of k sparign diuretics
hyperaldosternosim
K depletion
HF
23
toxo of K sparing diuretics
hyperkalaemia - arrhythmias
spironolactone - anti androgenic - gynecomastia
24
which diuretics increased urine NaCl
all but acetazolamide
serum NaCl may decrease as a result
25
which diuretics increased urine K
loops and thiazides
may descreased serum K as a result
26
which diuretics cause acidemia
carbonic anhydrase inhibitos
K sparing
27
which diuretics cause alkalemia
loops
thiazides
28
describe how carbonic anhydrase inhibitors cause acidemia
decreased HCO3 reabsorption
29
describe how K sparers caused acidemia
aldoseterone blockade prevents K secretion and H secrtion
increased K results in H out
30
describe how loops and thiazides cause alkalemia
volume contraction -- increasd AngII -- increased Na/H exchange and icnreasd HCO3 reabsorption CONTRACTION ALKALOSIS
K loss leads to exchange out K out for H in to cells
low K states, H si exchangd for Na in the corical collecting tubules -- paradoxical aciduria
31
what diuretics cause increased urine ca
loops - decreasd paracellular ca reabsorption -- hypocalcemia
32
which diuretcics caus decreasd urine ca
thiazides - enhanced Ca reabsorption in DCT
33
list the ACEi
captopril
enalapril
lisinopril
ramipril
34
MOA of ACEi
inhibit ACE -- decreased ANng II -- decreased GFR by prevention of constriction of efferent arterioles
icnreasd renin due to loss fo negative inhibition
prevents inacativation of bradykinin -- vasodilation
35
cx of ACEi
hypertension
HF
proteinuria
diabetic nephropathy
36
why are ACEi good in chronic hypertension
prevent unfavourable remodelling of heart
37
why are ACEi good in diabetes?
decreased intraglomerular pressure - slows GBM thickenign
38
toxo of ACEi?
Captoprils CATCHH
Cough
Angioedema - don't use with C1 esterase deficiency
Teratogen - fetal kidney abnormalities
Creatinine serum increased - decrease GFR
hyperkalemia
hypotencion
39
list the Ang II receptor blockers/ARBs
losartan
candesartan
valsartan
40
MOA of ARBs
selectively block binding of ant II to AT1 receptor
similar to ACEi but don't prevent breakdown of bradykinine
41
use of ARBs?
hypertension
HF
proteinuria
diabetic nephropathy
when ACEi aren't good (cough angioedema)
42