Renal-Pharmacology (USMLE)

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Name 4 K⁺-sparing diuretics.
Name 4 K⁺-sparing diuretics.
Spironolactone: competitive aldosterone receptor antagonist in the cortical collecting tubule
*endocrine effects (gynecomastia, antiandrogen effects)

Triamterene: blocks Na+ channels in the CCT

Amiloride: blocks Na+ channels in the CCT

eplerenone

The K+ STAys.

Name a newer and more selective aldosterone antagonist that may produce less endocrine effects than spironolactone.
Name a newer and more selective aldosterone antagonist that may produce less endocrine effects than spironolactone.
eplerenone

Mannitol MOA and use (3)
Mannitol MOA and use (3)
osmotic diuretic, increases tubular fluid osmolarity, producing increased urine flow
—–
shock

drug overdose

increased intracranial/intraocular pressure

Mannitol toxicity (2)
Mannitol toxicity (2)
pulmonary edema

dehydration

*contraindicated in anuria, CHF

Which diuretic can cause pulmonary edema?
mannitol

Name 2 endothelin-1 antagonists used to treat pulmonary hypertension.
bosentan

ambrisentan

List 2 prostaglandins used to treat pulmonary hypertension.
iloprost

epoprostenol

*vasodilation

List 2 cGMP phosphodiesterase inhibitors used to treat pulmonary hypertension.
tadalafil

sildenafil

Which class of calcium channel blockers can be used to treat pulmonary hypertension?
dihydropyridines (nifedipine)

What aldosterone antagonist (added to standard therapy) has been shown to significantly reduce morbidity and mortality in class 3 and 4 heart failure patients?
spironolactone

*most likely secondary to inhibition of the neurohormonal effects of aldosterone leading to decreased ventricular remodeling and cardiac fibrosis

Hydrochlorothiazide MOA and site of action
Hydrochlorothiazide MOA and site of action
inhibits NaCl reabsorption

early distal tubule

Which diuretics decreases calcium excretion?
thiazide diuretics

Thiazide diuretics use (3/4)
hypertension

CHF

idiopathic hypercalciuria

nephrogenic diabetes insipidus

Which diuretics can be used to treat idiopathic hypercalciuria?
thazide diuretics

Which diuretics can be used to treat nephrogenic diabetes insipidus?
thiazide diuretics

List 4 “HYPER” adverse effects of thiazide diuretics.
hypeuricemia

hypercalcemia

hyperglycemia

hyperlipidemia

List 2 “HYPO” adverse effects of thiazide diuretics.
hypokalemia

hypotension

What is the first-line medication for the treatment of essential hypertension in the general population?
hydrochlorothiazide

Which 2 diuretics are associated with sulfa allergies?
hydrochlorothiazide

furosemide

Loop diuretics MOA and site of action
Loop diuretics MOA and site of action
inhibits cotransport system (Na+, K+, 2Cl-)
*abolishes hypertonicity of medulla, preventing concentration of urine

thick ascending limb of loop of Henle

What prostaglandin is released by the action of loop diuretics?
PGE release

*vasodilatory effect on AFFERENT arteriole
*inhibited by NSAIDs

How do loop diuretics affect Ca2+ excretion?
increase excretion

Loop diuretics use (3/6)
CHF

cirrhosis

nephrotic syndrome

pulmonary edema

hypertension

hypercalcemia

Loop diuretics toxicity (3/6)
Ototoxicity (most often associated with ethacrynic acid)

Hypokalemia

Dehydration

Allergy (sulfa for furosemide)

Nephritis

Gout

OH DANG!

Name a loop diuretic that is a phenoxyacetic acid derivative.
ethacrynic acid

*NOT a sulfonamide

Acetazolamide MOA and site of action
Acetazolamide MOA and site of action
carbonic anhydrase inhibitor
*causes self-limited NaHCO3 diuresis and reductions in total body HCO3- stores

proximal convoluted tubule

Acetazolamide use (3/4)
glaucoma

urinary alkalinization

metabolic alkalosis

altitude sickness

Acetazolamide toxicity (3/4)
hyperchloremic metabolic acidosis

neuropathy

NH3 toxicity

sulfa allergy

ACIDazolamide causes ACIDosis.

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy Competitive inhibitors change Km or Vmax “Kompetitives change Km. Also K for POTency (POTassium)” Parameters of pharmacokinetics “ADME” Absorption, …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy Diuretics Prevent reabsorption of sodium and water by the kidneys What are diuretics used to treat? Hypertension (high blood …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy Drug classes to treat CHF? (4) 1. Diuretics 2. ACE-Inhibitors/ARBs 3. Beta Blockers 4. K-sparing Diuretics What type of …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy THIAZIDE DIURETICS MEDICATION? Hydrochlorothiazide (Diuril) THIAZIDE DIURETICS ROUTE OF ADMINISTRATION? PO WE WILL WRITE A CUSTOM ESSAY SAMPLE ON …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy Electrolytes Positively or negatively charged molecules Diuretic drugs What keeps sodium and potassium from being reabsorbed from the tubules …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy doxazosin Alpha-adrenergic blocker Causes dilation of arterioles and veins and relaxes sympathetic effect on bladder and urinary tract. Indicated …

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