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Pharm quiz 11/15
| Question | Answer |
|---|---|
| Diuretic Drugs | Drugs that accelerate the rate of urine formation Result: removal of sodium and water |
| Diuretic Drugs types | Carbonic anhydrase inhibitors Loop diuretics Osmotic diuretics Potassium-sparing diuretics Thiazide and thiazide-like diuretics |
| CAI: Mechanism of Action | CAIs blocks carbonic anhydrase= preventing exchange of H+ ions w/ Na & H20 distally to glomerulus Inhibit of carbonic anhydrase=↓ H+ ion concentration in renal tubules→ ↑ excretion of bicarb, Na+H2O & K+ Resorption H20 ↓ urine volume is ↑ |
| CAI drugs | acetazolamide (Diamox), methazolamide, Dichlorphenamide |
| Carbonic Anhydrase Inhibitors: Indications | Long management open angle glaucoma short term w/ miotics ↓ intraocular pressure Edema 2nd to HF=others aren’t effective CAI are ↓ potent loop diuretics/thiazides metabolic acidosis↓ diuretic effect in 2-4days Epilepsy High-altitude sick |
| CAI Adverse Effects | **Metabolic acidosis** Anorexia Hematuria Photosensitivity Melena (blood in stool) **Hypokalemia** Drowsiness Paresthesias Urticaria |
| CAI drug-drug interactions | Digitalis + coticosteroids b/c they both cause ↓ K+ Amphetamines, carbamazepine, cyclosporine, phenytoin, and quinidine can cause toxic (to those drugs) |
| Loop Diuretics | bumetanide (Bumex) ethacrynic acid (Edecrin) furosemide (Lasix) Torsemide |
| Lood Diuretics- MOA | Act directly on the ascending limb of the loop of Henle to inhibit Cl- & Na+ reabsorption b/p, PVR, SVR, CVP, LVEDP |
| Loop Diuretics: Drug Effects | Fast acting. Only last for 2 hours ↓ fluid volume causes: ↓BP ↓ pulmonary vascular resistance ↓ systemic vascular resistance ↓ central venous pressure ↓ left ventricular end-diastolic pressure Potassium and sodium depletion |
| Loop Diuretics: Contraindications | Allergy, sulfonamide antibiotics, hepatic coma, and severe electrolyte loss. Potassium levels 3-5.3 |
| Loop Diuretics: Adverse Effects | Dizziness, headache, tinnitus, blurred vision N/V/D Agranulocytosis, neutropenia, thrombocytopenia Hypokalemia, hyperglycemia,hyperuricemia **major adverse effect is electrolyte disturbance Prolong use can cause hearing loss from ototoxicity |
| Osmotic Diuretics MOA | Work in entire nephron osmotic effect Pull H20 into renal tubules from surrounding tissues Inhibits tubular resorption of H2O & solutes → ↑ diuresis vasodilation → prevents kidney damage during acute renal failure↓ excessive intraocular pressure |
| Osmotic Drugs | mannitol (Osmitrol) |
| Osmotic Indication | Used in the treatment in early oliguric phase of ARF To promote the excretion of toxic substances ↓ intracranial pressure Treatment of cerebral edema NOT indicated for peripheral edema b/c it doesn’t excrete ↑ Na+ |
| Osmotic Adverse Effects | Convulsions, Thrombophlebitis, Pulmonary congestion Also headaches, chest pains, tachycardia, blurred vision, chills, & fever |
| osmotic interventions | Intravenous infusion only. Filter is required May crystallize when exposed to low temperatures (keep in warm area) |
| Potassium-Sparing Diuretics Also known as aldosterone-inhibiting diuretics | amiloride (Midamor) spironolactone (Aldactone) triamterene (Dyrenium) |
| Potassium-Sparing Diuretics MOA | Work in collecting ducts/distal convoluted tubules Interfere with Na-K exchange Competitively bind to aldosterone receptors Block the resorption of Na& H20 Prevent K from being pumped into the tubule= no secretion ↑ excretion of Na& H20 |
| K sparing indications: | spironolactone and triamterene Hyperaldosteronism Hypertension Reversing the potassium loss → potassium-losing drugs Certain cases of heart failure Amiloride - Treatment of HF |
| K sparing ADR | CNS - Dizziness, headache; GI - Cramps, n/v/d; Other urinary frequency, weakness, **hyperkalemia** |
| Thiazide and Thiazide-like Diuretics | Thiazide diuretics bendroflumethiazide hydrochlorothiazide (Esidrix, HydroDIURIL) chlorothiazide (Diuril) indapamide Thiazide-like diuretics chlorthalidone (Hygroton) metolazone (Mykrox, Zaroxolyn) |
| Thiazide and Thiazide-like Diuretics: MOA | Inhibit tubular resorption of sodium, chloride, and potassium ions Action primarily in the distal convoluted tubule Result: water, sodium, and chloride are excreted Potassium is also excreted to a lesser extent Dilate the arterioles by direct relaxati |
| Thiazide and Thiazide-like Diuretics: indications | HTN, Edematous states,hepatic cirrhosis,corticosteroid/estrogen therapy Idiopathic hypercalciuria DI, HF from diastolic dysfunction **Thiazides shouldn't be used if creatinine clearance is <30-50 mL/min (WNL 125 mL/min) |
| Thiazide and Thiazide-like Diuretics ADR: | Dizziness, HA, blured vision, paresthesia, decreased libido, anorexia, N/V/D, pancreatitis, cholecystitis, impotence, jaundice, leukopenia, agranulocytosis, anemia, urticaria, photosensitivity, hypokalemia, hypochloremic alkalosis, hyperuricemia, |
| Thiazide and Thiazide-like Diuretics drug interactions | Corticosteroids Lithium Digoxin Diazoxide NSAIDS Oral hypoglycemia |
| Angina | Chest pain |
| Ischemia | Poor blood supply to the heart muscle Atherosclerosis Coronary artery disease |
| Myocardial Infarction (MI) | Necrosis, or death, of cardiac tissue Disabling or fatal Turns into scare tissue |
| Drugs for angina | * b(beta)-blockers Nitroglycerin * Calcium channel blockers |
| Nitrates :NTG | Vasodilation relaxation of smooth muscle |
| NTG: conraindications | Drug allergies, severe anemia, closed-angle glaucoma, hypotension, severe head injury Erective dysfunction drugs: |
| NTG: ADR | HA, Tachycardia, postural hypotension |
| NTG implications | Never to chew or swallow,Constipation is a common problem Avoid alcohol, hot tubs, saunas, excessive exertions vaso dila Lie down after administration |
| Beta blockers- end in "olol" | Angina Antihypertensive |
| Bete Blocker drugs | metoprolol (Lopressor)= less side effects *nadolol (Corgard) |
| Beta Blocker ADR | Bradycardia,fatigue, impotence, |
| Calcium channel blockers | *diltiazem (Cardizem) *amlodipine (Norvasc) |
| Ca Channel blockers implications: | weight gain > 2 lbs./day or > 5 lbs/week, pulse rates < 60, and any dyspnea |
| Antihistamines | MOA: decrease histamine effects: ADR:drowsiness, Contrain: drug allergy Drugs:loratadine (claritin) (nonsedating) Diphenhydramine (Benadryl) (nonsedating) |
| Decongestants | MOA: shrink engorged nasal mucous and relieve nasal stuffiness ADR: insomnia, palpitations. & temors Contrain: allergy |
| Antitussives | MOA: suppress coughing ADR: dizziness, HA, N/V, sedation, constipation, lightheadedness, Contrain: allergy, high risk for respiratory depression Drugs: dextromethorpham, |
| Expectorants | MOA: reflex stimulation (loosens & thins secretions), stimulation of secretory glands in respiratory tract, ADR:N/V gastric irritation Contrain: allergy Drug: guasigenesin |
| Dx of Respiratory System | Astma, Chronic bronchitis, Emphysema |
| Beta-adrenergic agonists | MOA: Dilate airways by stimulating beta2 adrenergic receptors ADR: insomnia, restlessness, anorexia, hyperglycemia, tremors, and vascular HA, Contain: allergy, uncontrolled dysrhythmias, high risk of CVA Drugs: albuterol, sameterol |
| Anticholinergics | MOA: Block ACh receptors to prevent bronchoconstriction= airway dilation ADR: dry mouth, nasal congestion, palpitations, GI upset, HAA, coughing, Contrain: allergy (atropine and or soy lecithi) Drugs: ipratropium |
| Xanthine derivatives | MOA: Bronchodilation by increasing energy-producing substance cAMP ADR: N/V anorexia Contrain: allergy, uncontrolled dysrhythmias, seizures, hyperthyroidism, peptic ulcers Drugs: theophylline |
| Leukotriene Receptor Antagonists | MOA: block inflammatory process in asthma ADR: HA, dyspepsia, N, dizziness, insomnia monitor liver enzyme Contrain: allergy (povidone, lactose, titanium, cellulose derivatives) Drugs: montelukast |
| Corticosteroids | MOA: reducing inflammation and enhancing activity of beta agonist ADR: pharyngeal irritation, coughing, dry mouth,oral fungal infections Contrain: allergy Drugs: fluticasone propionate, methylprednisolone |
Created by:
ethompso08
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