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USMLE
Renal Pharm
| Question | Answer |
|---|---|
| MOA of mannitol | (osmotic diuretic); increases tubular fluid osmolarity, thereby increasing urine flow |
| Clinical uses of mannitol | shock, drug OD, to decrease intracranial/intraocular P |
| MOA acetazolamide | carbonic anhydrase inhibitor; causes self-limited NaHCO3 diuresis and reduction in total-body bicarb stores |
| Clinical uses of acetazolamide | glaucoma, urinary alkalinization, metabolis alkalosis, altitute sickness |
| toxicities of acetazolamide | hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy |
| MOA of ethacrynic acid | (diuretic); phenoxyacetic acid derivative--NOT sulfonamide--that works like furosemide (loop diuretic) |
| Clinical use of ethacrynic acid | diuresis in pts with sulfa allergy (b/c NOT a sulfonamide) |
| toxicity of ethacrynic acid | similar to furosemide (OH DANG) but can be used in hyperuricemia and no sulfa allergy |
| MOA of furosemide | sulfonamide loop diuretic; inhibits Na-K-2Cl contransporter of thick ascending limb; abolishes hypertonicity of medulla which prevents concentration of urine; increases Ca excretion |
| toxicity of furosemide | OH DANG! Ototoxicty, Hypokalemia, Dehydration, Allergy, Nephritis (interstitial), Gout |
| MOA hydrochlorothiazide | thiazide loop diuretic. Inhibits NaCl reabsorption in early distal tubule which reduces diluting capacity of nephron. |
| thiazide diuretics vs. loop diuretics with respect to calcium? | loop diuretics (furosemide, ethacrynic acid)--increase Ca excretion; thiazides DECREASE Ca excretion. |
| 4 K+ sparing diuretics | spironolactone, triamterene, amiloride, eplereone |
| MOA of spironolactone | competitive aldosterone R antagonist in cortical collecting tubule |
| MOA of triamterene | (K+sparer) block Na channels in CCT (same as amiloride) |
| MOA of amiloride | (K+sparer) blocks Na channels in CCT (same as triameterene) |
| Clinical use of K+ sparing diuretics | hyperaldosteronism, K+ depletion, CHF |
| toxicity of K+ sparing diuretics | hyperkalemia, endocrine effects (eg. Spironolactone--gynecomastia, antiandrogenics) |
| which diuretics decrease the blood pH (more acidic) | carbonic anhydrase inhibitors (acetazolamide), K+ sparers (spironolactone, triamterene, amiloride, eplererone) |
| which diuretics increase blood pH (make more basic) | loop diuretics (furosemide, ethacrynic acid), thiazides |
| 3 AcE inhibitors | captopril, enalapril, lisinopril |
| MOA of ACE inhibitors | inhibit angiotensin converting enzyme which reduces levels of angiotensin II and prevents inacitvation of bradykinin (potent vasodilator); renin release increased b/c of lack of feedback inhibition |
| effect of ACE inhibitors on renin release? | renin release increased due to loss of feedback inhibition |
| Clinical uses of ACE inhibitors | HTN, CHF, diabetic renal disease |
| toxicities of ACE inhibitors | CAPTOPRIL: cough, angioedema, proteinuria, taste changes, hypOtension, preggers problems, rash, increased renin, lower angiotension II. Also hyperkalemia. |
| can ACE inhibitors be used in bilateral renal artery stenosis? | no |
Created by:
Asclepius
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