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Renal
Pharmacology: Renal
| Question | Answer |
|---|---|
| Where do the following act in the renal tubule? 1. Carbonic anhydrase inhibitors 2. Thiazides 3. Aldosterone antagonist | 1. proximal convoluted tubule 2. distal convoluted tubule 3. collecting duct |
| Where do the following act in the renal tubule? 1. furosemide 2. mannitol 3. ADH antagonist | 1. ascending limb 2. loop of henle 3. collecting duct |
| What is the mechanism of action of Acetazolamide that contributes to its effectiveness as a diuretic? | Carbonic anhydrase inhibitor. Prevents bicarb and H+ synthesis within the proximal tubule. Na+ is usually taken up in exchange for H+. Thus, biarb and Na+ are lost. |
| What are the clinical uses of carbonic anhydrase inhibitors? | 1. glaucoma 2. acute altitude sickness 3. edema accompanied by alkalosis |
| Mechanism of action of furosemide | inhibit the Na/K/Cl carrier in the ascending limb |
| How can loop and thiazide diuretics result in hypokalemic metabolic alkalosis? | 1. by inhibiting Na reabsorption in ascending loop of Henle and DCT respectively, more Na is presented to the collecting tubule 2. Na/K+ exchangers secrete K+ 3. Na/H exchanges secrete H+ |
| 1. Mechanism of action of amiloride and triamteren 2. Mechanism of action of spironolactone and eplerenone | 1. block electrogenic Na+ channel in collecting duct 2. aldosterone antagonist |
| 1. treatment of Conn's syndrome? 2. Which diuretics cause hyperuricemia? Why? | 1. spironolactone 2. thiazides 3. loop diuretics and thiazides compete with urate for active secretion into proximal tubule |
| 1. Patient with sulfa allergy needs a diuretic 2. Diuretic causing hypocalcemia and hypomagnesemia. | 1. Ethacrynic acid 2. Loop diuretic (positive charge buildup in lumen prevents passive reabsorption of Ca2+ and Mg2+) |
| 1. Most potent diuretic class 2. Which diuretic can help reduce motality in heart failure | 1. loop diuretics 2. Spironolactone |
| 1. Diuretic causing hypercalcemia. 2. Why? | 1. Thiazide 2. Since the luminal NaCl symporter is inactivated, the basolateral Na/Ca antiporter attempts to draw more Na+ into the distal tubule cell causing more Ca2+ to enter blood stream. |
| Diuretic causing ototoxicity | Ethacrynic acid |
| Mechanism of action of Losartan | angiotensin II receptor antagonist |
| Which diuretic is contraindicated with bialteral renal artery stenosis? | ACE inhibits because they significantly ↓ GFR |
| Why do ACE inhibits cause angioedema? | ACE breaks down bradykinin. With inhibitor, bradykinin accumulates. |