Renal Pharmacology (Jensen's video lecture) Flashcards
(40 cards)
1
Q
Diuretics - therapeutic actions
A
- Increase nephron osmolality
- Increase urine excretion
- Decrease fluid electrolytes
2
Q
Diuresis
A
- Excretion of a large amount of urine
3
Q
Diuretic
A
- Drug that causes diuresis
4
Q
Naturesis
A
- Excretion of a large amount of sodium in the urine
5
Q
Naturetic
A
- Drug that causes naturesis
6
Q
Hyponatremia
A
- Reduced amount of sodium in the blood
7
Q
Hypernatremia
A
- Excess amount of sodium in the blood
8
Q
Kaluresis
A
- Excretion of a large amount of potassium in the urine
9
Q
Kaluretic
A
- Drug that causes kaluresis
10
Q
Hypokalemia
A
- Reduced amount of potassium in the blood
11
Q
Hyperkalemia
A
- Excess amount of potassium in the blood
12
Q
Diuretics
A
- Mannitol
- Hydrochlorothiazide (HCTZ)
- Furosemide
- Spironolactone
- Triamterene
13
Q
Mannitol - category
A
- Diuretic
14
Q
Mannitol - MOA
A
- Osmotic diuretic
- Filtered from glomerulus into nephron, not reabsorbed from nephron, thereby increasing osmolality in nephron, and retaining water in neprhon
15
Q
Mannitol - distinguishing characteristics
A
- Sugar alcohol derived from mannose
- Poorly absorbed from GI tract
- Not metabolized
- Excreted unchanged in urine
- Urinary excretion equal to dose
16
Q
Mannitol - predictable actions
A
- Administered intravenously
- Water diuresis proportional to dose
- Very efficacious at high dose
- Used to reduce elevated intracranial pressure
17
Q
Hydrochlorothiazide - trade name
A
- Hydrodiuril
18
Q
Hydrochlorothiazide - category
A
- Diuretic
19
Q
Hydrochlorothiazide - MOA
A
- Reduces reabsorption of sodium, chlorine, and potassium from distal convoluted tubules
20
Q
Hydrochlorothiazide - distinguishing characteristics
A
- Contains sulfonamid group
- Weak vasodilation
- Less efficacious and less potent than loop diuretics, but can still be highly efficacious
21
Q
Hydrochlorothiazide - predictable actions
A
- Diuresis
- Naturesis
- Kaluresis
- Chlorouresis
- Used to treat edema in CHF
- Used to treat hypertension
- Occasional hypersensitivity reactions (sulfonamide)
22
Q
Furosemide - trade name
A
- Lasix
23
Q
Furosemide - category
A
- Diuretic
24
Q
Furosemide - MOA
A
- Inhibit reabsorption of sodium, chlorine, and potassium in thick, ascending limp of loop of Henle
25
Furosemide - distinguishing characteristics
- Highly efficacious - "High Ceiling"
- Can administer orally and intravenously
- Reversible ototoxicity, esp with aminoglycosides
- Contains sulfonamide group
- Enhanced uric acid reabsorption
26
Furosemide - predictable actions
- Heavy diuresis, naturesis, kaluresis, and chlorouresis
- Hypokalemia
- Dehydration
- Weakness
- Hypotension
- Used to treat CHF and edema
- Hypersensitivity reactions (sulfonamide)
- Hyperuricemia and worsening of gout
27
Triamterene - trade name
- Dyrenium
28
Triamterene - category
- Diuretic (potassium-sparing)
29
Triamterene - MOA
- Reabsorbs sodium from proximal tubule in exchange for potassium
30
Triamterene - distinguishing characteristics
- Potassium sparing
- Weak diuretic (low efficacy)
- Contributes to nephrolithasis
31
Triamterene - predictable actions
- Modest naturesis
- Counteracts kaluresis of other diuretics
- Alternative to potassium therapy
- Used in conjunction with other potassium-wasting diuretics
32
Spironolactone - trade name
- Aldactone
33
Spironolactone - category
- Diuretic (potassium saving)
34
Spironolactone - MOA
- Aldosterone antagonist
| - Prevents potassium secretion in exchange for sodium in collecting duct
35
Spironolactone - distinguishing characteristics
- Steroid (similar to aldosterone and testosterone)
| - Protects heart from some structural changes in CHF
36
Spironolactone - predictable actions
- Potassium saving
- Possible hyperkalemia with high doses
- Occasional gynecomastia, impotence, and BPH
- Improves survival in CHF more than other potassium saving diuretics
- Numerous off-label uses due to inhibition of other steroids
- Naturesis and diuresis
37
Potassium - category
- Electrolyte
38
Potassium - MOA
- Exchanges with sodium and other electrolytes to maintain membrane electrical potential
39
Potassium - distinguishing characteristics
- Available in enteric-coated tablets to prolong absorption time
- Often causes abdominal distress, including vomiting and diarrhea
40
Potassium - predictable actions
- Replacement therapy following diuresis
- May produce hyperkalemia
- Excess may cause bradycardia
