Renal I Flashcards Preview

Board Review - B - Systems Pharmacology > Renal I > Flashcards

Flashcards in Renal I Deck (48)
1

mannitol MOA

osmotic diuretic

2

adverse mannitol

pulmonary edema
dehydration

CI in heart failure

3

mannitol clinical use

drug overdose
elevated intracranial/intraocular pressure

4

acetazolamide MOA

carbonic anhydrase inhibitor

decrease total body HCO3 stores

5

acetazolamide clinical use

glaucoma
urinary alkalinization
metabolic alkalosis
altitude sickness
pseudotumor cerebri - high pressure in skull

6

acetazolamide adverse

hyperchloremic metabolic acidosis
paresthesia
NH3 toxicity
sulfa allergy

7

furosemide

loop diuretic

8

bemetanide

loop diuretic

9

torsemide

loop diuretic

10

loop diuretic MOA

inhibit cotransport Na/K/2Cl thick ascending limb

prevent concentration of urine

stimulate PGE release - vasodilatory effect
-inhibited by NSAIDs

incrased Ca excretion - hypoCa

11

clinical use loop diuretics

edematous state - HF, cirrhosis, nephrotic syndrome, pulmonary edema

HTN

hyperCa

12

adverse loop diuretics

ototoxicity
hypoK
ehydration
sulfa allergy
nephritis - interstitial
gout

13

ethacrynic acid

non - sulfonamide loop diuretic

14

clinical use ethacrynic acid

sulfa allergy - diuresis tx

15

chlorthalidone

thiazide diuretic

16

thiazide diuretic MOA

inhibit NaCl reabsorption - early DCT
-decreased diluting capacity of nephron

decrease Ca excretion

17

thiazide clinical use

HTN
heart failure
idiopathic hyperCa
nephrogenic DI
osteoporosis

18

adverse thiazide

hypoK metabolic alkalosis
hypoNa
hyperglycemia
hyperlipidemia
hyperuricemia
hyperCa

sulfa allergy

19

spironolactone

aldosterone antagonist - K sparing

20

eplerenone

aldosterone antagonist - K sparing

21

triamterene

Na channel blocker - K sparing

22

amiloride

Na channel blocker - K sparing

23

K sparing MOA

aldosterone antagonist in collecting tubule

or as Na channel blocker collecting tubule

24

K sparing clinical use

hyperaldosteronism
K depletion
heart failure

25

adverse K sparing

hyperK - arrhythmia
endocrine effect - spironolactone - gynecomastia, antiandrogen effects

26

diuretics

acetazolaminde
mannitol
loops
thiazides
K sparing

27

acid base with CAIs

acidemia
-decreased bicarb reabsorption

28

acid base with K sparing

acidemia
-aldosteorne block - prevent K secretion and H secretion

also - hyperK leads to K entering all cells in exchange for H

29

acid base with loops

alkalemia - volume contraction
-increased angiotensin II - more Na/H exchange PCT > more bicarb reabsorption (contraction alkalosis)

K loss - leads to K exiting cells exchange for H entering cell

low K state - H exchanged for Na in cortical collecting tubule

30

acid base with thiazides

alkalemia - volume contraction
-increased angiotensin II - more Na/H exchange PCT > more bicarb reabsorption (contraction alkalosis)

K loss - leads to K exiting cells exchange for H entering cell

low K state - H exchanged for Na in cortical collecting tubule

31

urine Ca with loops

decreased paracellular Ca reabsorption

increased urine Ca

32

urine Ca with thiazides

enhanced Ca reabsorption - DCT

decreased urine Ca

33

urine potassium

increased with loops

34

captopril

ACE inhibitor

35

ramipril

ACE inhibitor

36

ACE inhibitor mechanism

inhibit ACE
-decreased ANG II > decreased GFR
-decreased constriction efferent arterioles

renin increase - loss of feedback

also prevent inactivation of bradykinin

37

ACE inhibitor clinical use

HTN, HF, proteinuria

diabetic nephropathy

prevent unfavorable heart remodeling

38

adverse ACE inhibitor

cough
angioedema - lots of bradykinin
teratogen
creatinine increase
hyperKa
hypotension

39

avoid in B/L renal artery stenosis

ACE inhibitor - because will further decrease GFR > renal failure

40

losartan

ANG II blocker

41

candesartan

ANG II blocker

42

valsartan

ANG II blocker

43

ANG II blocker MOA

block ANG II binding AT1 receptor

44

clinical use ANG II blocker

HTN
HF
proteinuria
diabetic nephropathy

45

adverse ANG II blocker

hyperK
decreased renal function
hypotension
teratogen

46

aliskiren

direct renin inhibitor

block conversion angiotensinogen to ANG I

47

clincal use aliskiren

HTN

48

adverse aliskiren

hyperK
decreased renal f unction
hypotension

CI - diabetic taking ACE I or ARBs