The Kidney and Drugs

Question 1

Bumetanide is an example of what type of drug?

Answer 1

Loop diuretic

Question 2

Loop diuretics work by blocking the action of what?

Answer 2

Na+/K+/2Cl- triple co-transporter

Question 3

Where in the nephron do loop diuretics exert their effect?

Answer 3

Thick ascending loop of Henle

Question 4

Loop diuretics have what effect on all ion concentrations in the blood?

Answer 4

Decreased

Question 5

How long does it take for loop diuretics to act when given orally or IV?

Answer 5

1 hour if given orally, 30 minutes if given IV

Question 6

Loop diuretics are usually used to treat what?

Answer 6

Peripheral or pulmonary oedema

Question 7

What electrolyte abnormality can loop diuretics be used to treat?

Answer 7

Hypercalcaemia

Question 8

Which acid-base disorder is caused by the use of loop diuretics?

Answer 8

(Hypokalaemic) metabolic alkalosis

Question 9

Which group of diuretic drugs are ototoxic? This side effect is enhanced if they are used alongside which other drug?

Answer 9

Loop diuretics cause ototoxicity which is enhanced when used alongside gentamicin

Question 10

Metolazone is an example of what type of drug?

Answer 10

Thiazide diuretic

Question 11

Thiazide diuretics work by blocking the action of what?

Answer 11

Na+/Cl- co-transporter

Question 12

Where in the nephron do thiazide diuretics exert their effect?

Answer 12

Distal convoluted tubule

Question 13

In someone using a thiazide diuretic, what happens to the level of calcium in the blood?

Answer 13

High (hypercalcaemia)

Question 14

In someone using a thiazide diuretic, what happens to the level of calcium in the urine?

Answer 14

Low (hypocalciuria)

Question 15

Thiazide diuretics lead to reduced excretion of uric acid. This leads to what side effect?

Answer 15

Gout

Question 16

Thiazide diuretics are used in the treatment of what?

Answer 16

Hypertension and long-term oedema

Question 17

Which type of diuretic can be used to reduce renal stone formation in patients with idiopathic hypercalciuria?

Answer 17

Thiazides

Question 18

What effect do thiazide diuretics have on blood glucose levels?

Answer 18

Increased (hyperglycaemia)

Question 19

How do spironolactone and eplerenone work as potassium sparing diuretics?

Answer 19

They are aldosterone antagonists

Question 20

How do amiloride and triamterene work as potassium sparing diuretics?

Answer 20

They block sodium reabsorption in the collecting duct

Question 21

Which type of potassium sparing diuretic has a faster onset of action - spironolactone or amiloride?

Answer 21

Amiloride

Question 22

Why are potassium sparing diuretics usually given in combination with another type of diuretic?

Answer 22

Because alone there is a risk of hyperkalaemia

Question 23

Which acid-base disorder can be caused by the use of potassium sparing diuretics?

Answer 23

Metabolic acidosis

Question 24

Which type of diuretic drugs cause anti-androgenic side effects e.g. gynaecomastia?

Answer 24

Aldosterone antagonists (a type of potassium sparing diuretic)

Question 25

Mannitol is an example of what type of drug?

Answer 25

Osmotic diuretic

Question 26

Which is the only type of diuretic to be freely filtered at the glomerulus?

Answer 26

Osmotic diuretics

Question 27

At which points in the nephron do osmotic diuretics exert their effect?

Answer 27

Proximal convoluted tubule and loop of Henle

Question 28

Osmotic diuretics are usually used for what clinical purpose?

Answer 28

To reduced intra-ocular or intra-cranial pressure

Question 29

What are some side effects of osmotic diuretics?

Answer 29

Headache, nausea and vomiting

Question 30

Acetazolamide is an example of what type of drug?

Answer 30

Carbonic anhydrase inhibitor

Question 31

Carbonic anhydrase inhibitors exert their diuretic effect through increasing the excretion of what?

Answer 31

Bicarbonate (and hence sodium)

Question 32

Carbonic anhydrase inhibitors act on what portion of the nephron?

Answer 32

Proximal convoluted tubule

Question 33

Carbonic anhydrase inhibitors are used mainly in the treatment of what condition?

Answer 33

Glaucoma

Question 34

What effect do vasopressin 2 receptor antagonists have?

Answer 34

Excretion of water without accompanying sodium

Question 35

Tolvaptan is an example of what type of drug?

Answer 35

Vasopressin V2 receptor antagonist

Question 36

Name two conditions in which vasopressin 2 receptor antagonists are used as a treatment?

Answer 36

ADPKD and SIADH

Question 37

Canagliflozin and dapagliflozin are examples of what type of drug?

Answer 37

SGLT2 inhibitors

Question 38

SGLT2 inhibitors are used in the treatment of what?

Answer 38

Type 2 diabetes

Question 39

The SGLT2 transporter, inhibited by SGLT2 inhibitors, is located on which part of the nephron?

Answer 39

Proximal convoluted tubule

Question 40

What effect do SGLT2 inhibitors have on weight?

Answer 40

Weight loss

Question 41

What is the most common adverse effect of SGLT2 inhibitors?

Answer 41

Genital infections (bacterial and fungal)

Question 42

A combination of an aminoglycoside with which other group of drugs is particularly nephrotoxic?

Answer 42

Loop diuretics

Question 43

What type of drugs may cause renal damage by causing crystal nephropathies?

Answer 43

Antivirals