Trachte

Question 1

loop diuretics

Answer 1

furosemide

bumetanide

Question 2

loop diuretics mech

Answer 2

• block Na/K/2Cl transport in ascending limb of loop of Henle
• accounts for 25% Na reabsorption
• dramatically increases Na, K, and H20 EXCRETION

Question 3

thiazide diuretic

Answer 3

chlorthalidone
hydrochlorathiazide
metalozone

Question 4

thiazide diuretic mech

Answer 4

• block Na/Cl transport in distal convoluted tubule
• accounts for 8% Na reabsorption
• MILDER increase in Na and K EXCRETION (than loop diuretics)

Question 5

potassium sparing diuretics

Answer 5

spironolatcone
eplerenone
amiloride
triamterene

Question 6

potassium sparing diuretics mech

Answer 6

• block ALDO receptors (spironolactone and eplerenone)
• block the Na exchange for K and H (amiloride and triamterene)
• MILD diuretics, primarily prevent excessive K wasting = block exchange of Na/K in collecting tubule

Question 7

ADH and desmopressin

Answer 7

• increase aquaporin channels in collecting duct

- allows CONCENTRATION OF URINE

Question 8

osmotic diuretics

Answer 8

mannitol

Question 9

osmotic diuretic mech

Answer 9

exert osmotic effect in proximal tubule to REDUCE H2O REABSORPTION

Question 10

SGLT-2 inhibitors

Answer 10

canigliflozin

Question 11

SGLT-2 inhibitors mech

Answer 11

• reduces glucose reabsorption

Question 12

carbonic anhydrase inhibitors

Answer 12

acetazolamide

Question 13

carbonic anhydrase inhibitor mech

Answer 13

• block the reabsorptive processes in proximal tubule

- major utility in glaucoma or excess CSF production or urinary alkalinization

Question 14

probenicid

sulfinpyrazone

Answer 14

• suppress uric acid reabsorption in gout

Question 15

microtubule inhibitor in gout

Answer 15

colchicine

- suppress uric acid reabsorption in gout

Question 16

xanthine oxidase inhibitor

Answer 16

allopurinol

- suppress uric acid reabsorption in gout

Question 17

therapeutic uses loop diuretics

Answer 17

1. pulmonary edema
2. other edematous condition
3. hyperkalemia
4. acute renal failure
5. anion overdose (bromide, fluoride, iodide)

Question 18

loop diuretic effect on urine

Answer 18

• increase NaCl excretion

- increase K excretion

Question 19

why is some K excreted when trying to rid NaCl?

Answer 19

increased Na in lumen exchanged for K in cortical collecting tubule

Question 20

therapeutic uses of thiazides

Answer 20

1. HTN
2. HF
3. nephrolithiasis caused by hypercalcemia
4. nephrogenic diabetes insipidus

Question 21

major SE thiazides

Answer 21

• HYPERGLYCEMIA (thiazides bind to SUR on K channel controlling insulin release –> opens channel –> K enters –> hyperpolarizes beta cell –> suppress insulin release)
• hyperuricemia
• hypokalemia
• hyperlipidemia
• hyponatremia
• allergic rxn

Question 22

aldosterone receptor inhibitors

Answer 22

spironolactone

eplerenone

Question 23

Na/K/H exchange in cortical collecting duct inhibitors

Answer 23

amiloride

triamterene

Question 24

therapeutic uses K sparing diuretics

Answer 24

• hyperaldosteronism***

- prevent K wasting caused by other diuretics

Question 25

SE of K sparing diuretics

Answer 25

- hyperkalemia - hyperchloremia metabolic acidosis - gynecomastia (spironolactone) - acute renal failure - kidney stones

Question 26

vasopressin (ADH)/desomopressin used to treat

Answer 26

- diabetes insipidus | - bed wetting

Question 27

vasopressin (ADH)/desmopressin mech

Answer 27

stimulation G-protein coupled receptors in collecting duct --> recruit aquaporin channels = water moves by osmosis through aquaporin to the hyperosmolar medullary region of kidney*

Question 28

osmotic diuretics

Answer 28

mannitol

Question 29

osmotic diuretic mech

Answer 29

mannitol isn't reabsorbd in nephron --> osmotic effect --> lumen to retain water

Question 30

osmotic diuretic uses

Answer 30

reduce body water or reduce intracranial or intraocular pressure

Question 31

mannitol SE/toxicities

Answer 31

- extracellular volume expansion - dehydration, hyperkalemia, hypernatremia - hyponatremia when renal function impaired

Question 32

SGLT-2 inhibitors effects

Answer 32

- loss of glucose in urine - reduce blood sugar levels in DM - weight loss (due to loss of energy/glucose) - SE: ketoacidosis, URIs, yeast infection, hypoglycemia

Question 33

treatment of gout

Answer 33

- reduce inflammation with NSAIDS (don't use ASAs) - reduce uric acid (allopurinol, probenicid, sulfinpyrazone inhibits WOA --> promotes excretion) - allopurinol - colchicine