Renin Angiotensin Aldosterone System and Diuretics Flashcards Preview

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Flashcards in Renin Angiotensin Aldosterone System and Diuretics Deck (16)
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1
Q

Angiotensin Converting Enzyme Inhibitors (ACEIs)

  1. ) Drugs available ?
  2. ) Indication?
  3. ) protection effect?
  4. ) ADR’s?
A

1.) agents that end it “pril”

2.)
HTN-post MI
Systolic HF
Chronic Kidney Disease

3.)
Has renal protection effect, BUT can cause acute renal failure when first taken

4.)
•Dry cough (5-20%)difference maker b/w ACEI’s and ARBs
•Angioedema
•Hyperkalemia

2
Q

Angiotensin Receptor Blockers (ARB’s)

  1. ) Drugs available ?
  2. ) Indication?
  3. ) protection effect?
  4. ) ADR’s?
A

1.) • Anything that ends in ‘Sartan’
o Like Losartan

2.)
• HTN-Post MI
• Heart Failure
• Chronic kidney disease protection → potential for initial AKI

3.)Has renal protection effect, BUT can cause acute renal failure when first taken

4.)
• Angioedema (potential cross-sensitivity with ACEI’s)
o Less likely to develop then ACEI’s
• Hyperkalemia Less aldosteroneLess K retention
o Important with DDIs

3
Q

Sacubitril
1.) Indication?

  1. ) Drug Class?
  2. ) Should be combined with and why?
A
  1. ) For Heart failure
  2. ) Neprilysin Inhibitor (ANRI)

3.)Sacubitril + ARB
→ Not and ACEI because they both increase bradykinin

4
Q

Furosemide

  1. ) Drug class
  2. ) Indication?
  3. ) ADR?
A
  1. ) Loop Diuretic
  2. ) CHF/Edema
3.) ADRs
•	Hypo-K
•	Hypo-Ca
•	Hypo-Mg
•	Hyper-Uricemia 
•	Hypovolemia
•	Hypotension
•	Ototoxic (IV) (having an effect on the ear or nerve supply)
5
Q

Torsemide

  1. ) Drug class
  2. ) Indication?
  3. ) ADR?
A
  1. ) Loop Diuretic
  2. ) CHF/Edema
3.) ADRs
•	Hypo-K
•	Hypo-Ca
•	Hypo-Mg
•	Hyper-Uricemia 
•	Hypovolemia
•	Hypotension
•	Ototoxic (IV) (having an effect on the ear or nerve supply)
6
Q

Bumetanide

  1. ) Drug class
  2. ) Indication?
  3. ) ADR?
A
  1. ) Loop Diuretic
  2. ) CHF/Edema
3.) ADRs
•	Hypo-K
•	Hypo-Ca
•	Hypo-Mg
•	Hyper-Uricemia 
•	Hypovolemia
•	Hypotension
•	Ototoxic (IV) (having an effect on the ear or nerve supply)
7
Q

Ethacrynic acid*

  1. ) Drug class
  2. ) Indication?
  3. ) ADR?
A
  1. ) Loop Diuretic
  2. ) CHF/Edema
3.) ADRs
•	Hypo-K
•	Hypo-Ca
•	Hypo-Mg
•	Hyper-Uricemia 
•	Hypovolemia
•	Hypotension
•	Ototoxic (IV) (having an effect on the ear or nerve supply)
8
Q

What diuretic can be used safely in sulfa allergies?

A

Ethacrynic acid*- loop diuretic

9
Q

Hydrochlorothiazide

  1. ) Drug class?
  2. ) Indication?
  3. ) ADR’s?
A
  1. ) Thiazide diuretics
  2. ) Common initial therapy for HTN; maybe in adjunct in CHF/edema
3.)ADR's
•	Hypo-K
•	Hypo-Mg
•	Hyper-Ca (in the blood)
•	Hyper-Uricemia
•	Hypovolemia 
•	Hypotension
10
Q

Chlorthalidone

A
  1. ) Thiazide diuretics
  2. ) Common initial therapy for HTN; maybe in adjunct in CHF/edema
3.)ADR's
•	Hypo-K
•	Hypo-Mg
•	Hyper-Ca (in the blood)
•	Hyper-Uricemia
•	Hypovolemia 
•	Hypotension
11
Q

Metolazone

A
  1. ) Thiazide diuretics
  2. ) Common initial therapy for HTN; maybe in adjunct in CHF/edema
3.)ADR's
•	Hypo-K
•	Hypo-Mg
•	Hyper-Ca (in the blood)
•	Hyper-Uricemia
•	Hypovolemia 
•	Hypotension
12
Q

Indapamide

A
  1. ) Thiazide diuretics
  2. ) Common initial therapy for HTN; maybe in adjunct in CHF/edema
3.)ADR's
•	Hypo-K
•	Hypo-Mg
•	Hyper-Ca (in the blood)
•	Hyper-Uricemia
•	Hypovolemia 
•	Hypotension
13
Q

Chlorothiazide

A
  1. ) Thiazide diuretics
  2. ) Common initial therapy for HTN; maybe in adjunct in CHF/edema
3.)ADR's
•	Hypo-K
•	Hypo-Mg
•	Hyper-Ca (in the blood)
•	Hyper-Uricemia
•	Hypovolemia 
•	Hypotension
14
Q

Thiazide diuretics can’t be used in pt’s with? Except?

A

CrCl < 30 except metolazone

15
Q

Spironlactone

  1. ) Drug Class?
  2. ) Indication?
  3. ) ADR’s?
  4. ) C/I?
A
  1. ) potassium sparing diuretics–aldosterone antagonist
  2. ) Use in CHF/HTN/MI (E>S)

3.) Adverse Effects:
• Hyper-K***
→ C/I with other potassium sparing agents (ACEIs/ARBs)

•	Endocrine ADRs (S>>>E)
o	Gynecomastia
o	Impotence 
•	Hyper-Uricemia
•	Arrhythmias 

4.) C/I with ACEI’s and ARBs
→ ACEI’s and ARBs have an ADR of Hyperkalemia as well so the combination could cause an Arrhythmia

16
Q

Eplerenone

  1. ) Drug Class?
  2. ) Indication?
  3. ) ADR’s?
  4. ) C/I?
A
  1. ) potassium sparing diuretics -aldosterone antagonist
  2. ) Use in CHF/HTN/MI (E>S)

3.) Adverse Effects:
• Hyper-K***
→ C/I with other potassium sparing agents (ACEIs/ARBs)

•	Endocrine ADRs (S>>>E)
o	Gynecomastia
o	Impotence 
•	Hyper-Uricemia
•	Arrhythmias 

4.) C/I with ACEI’s and ARBs
→ ACEI’s and ARBs have an ADR of Hyperkalemia as well so the combination could cause an Arrhythmia