Term
Acetazolamide MOA, site of action, use, adverse effects |
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Definition
MOA: Carbonic anhydrase inhibitor site: proximal tubule Use: glaucoma and altitude sickness (respiratory alkalosis) Adverse: kidney stones, metabolic acidosis
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Term
Spironolactone MOA, site of action, use, adverse effects |
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Definition
MOA: aldosterone antagonist (k+ sparer)
Site: late distal tubule and collecting duct
use: offset K+ wasting of other diuretics, hyperaldosteronism Adverse: hyperkalemia, gynecolmastia, impotence *not a sulfonamide
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Term
hydrochlorothiazide MOA, site of action, use, adverse effects |
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Definition
MOA: inhibit Na+ Cl- symport
site: in early distal tubule use: chronic HTN, edema, kidney stones b/c inc Ca+ reabsorption* furosemide is more efficacous for edema)
adverse: (same as loops but to a lesser extent) K+ and H+ loss, uric acid retention
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Term
furosemide MOA, site of action, use, adverse effects |
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Definition
MOA: loop diuretic inhibits Na+, K+,2Cl- symport
site: ascending loop of Henle use: acute edema, pulmonary edema, HTN chrisis (too efficacous for chronic HTN) Adverse: Same as thiazides but to a higher extent) K+ and H+ loss, hypokalemia, uric acid retention
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Term
Amiloride MOA, site of action, use, adverse effects |
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Definition
MOA: Na+ channel blocker (k+ sparer)
Site: late distal tubule and collecting duct
use: offset K+ wasting of other diuretics Adverse: *not a sulfonamide
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Term
| drugs that dont cause gout |
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Definition
K+ sparring and ACE-I/ARB (Aldosterone antagonist and Na+ channel blockers) Triamterene, Spironolactone, Amiloride |
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Term
| good drug for a patient with severe hypercalcemia |
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Definition
| loop diuretics- furosemide because they cause Mg+2 and Ca+2 loss |
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Term
| how do loop diuretics cause hypokalcemia (K+)? |
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Definition
| they increase the amount of sodium (Na+) that reaches the collecting duct |
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Term
| which drug class will most likely cause severe hypokalemia? |
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Definition
| loop diuretics- furosemide because they have the most efficacous effects and because there are few options down stream to reabsorb K+ after the ascending loop of Henle |
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Term
Enalapril MOA, site of action, use, adverse |
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Definition
MOA: ACE-I Site: everywhere in the vascular system use: HTN adverse: hypotension, hyperkalemia, fetal defects, dry cough/angioedema (due to increased bradykinin)
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Term
Losartan MOA, site of action, use, adverse |
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Definition
MOA: competative antagoinism ARB/ AT1 receptor blocker Site: use: HTN adverse: hypotension, hyperkalemia, fetal defects, *NO dry cough/angioedema |
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Term
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Definition
Captopril causes skin rash more frequently than Enalapril Captopril can also leave a bad taste in your mouth Captopril is the only ACE-I that has a sulfur |
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Term
| medications not to take in combination due to increased Hyperkalemia risk |
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Definition
| ACE/ARB with K+ sparers (aldosterone antagonists and Na+ channel blockers) |
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Term
| drugs to avoid during pregnancy |
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Definition
ACE and ARB's (AT1) in 2nd and 3rd trimesters are there others? |
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Term
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Definition
MOA: thiazide- inhibits Na+ Cl-symport site: early distal tubule very similar to HCTZ
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Term
| what drug class will most likely cause an increase in serum calcium concentrations? |
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Definition
Thiazides such as HCTZ and chlorthalidone becasue they are used for kidney stones and will increase Ca+ reabsorption
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Term
what would the most appropriate drug be for a patient that has HTN due to adrenal hyperplasia/ very high aldosterone levels?
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Definition
| Spironolactone- an aldosterone antagonist |
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Term
| what class of drugs has the side effect of ototoxicity? |
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Definition
| loop diuretics- furosemide |
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Term
| BOB the bear thought eye drops were too wimpy to use for his glaucoma so he took acetazolamide by mouth instead and now has kidney stones. what can he take to reduce the size of the kidney stones? |
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Definition
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Term
what drug classes should you check if the patient is taking a potassium supplement? |
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Definition
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Term
| ACE / ARB protective effects: |
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Definition
they inhibit cardiac remodeling, and dont elevate cholesterol levels, and dont lower potassium levels also have kidney protective effects in diabetics |
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Term
| bradykinin antagonist would have what effect? |
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Definition
| prevent angioedema and cough while on enalapril |
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Term
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Definition
MOA: osmotic diuretic site proximal tubule and descending loop use: edema, Ca+ homeostasis |
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Term
what will a decrese in blood pressure do to renin levels? |
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Definition
renin will increase to increase Na+ retention and vasoconstriction Result: atrial blood pressure will increase |
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Term
| rate limiting step in the renin-angiotension system is________ |
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Definition
renin production in the kidney is the rate limiting step |
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Term
renin regulation (3 ways) |
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Definition
1 macula densa signal (decreased Na, K, 2Cl entering will increase renin release 2 decreased tension in affarent arterioles will increase cAMP and renin 3 decrease BP/ baroreceptor activity will increase cAMP and renin release |
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Term
AT1 binding to Angiotensin II receptor causes(MOA): |
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Definition
G-protein mediated influx of Ca++ which stimulates calmodulin to cause vasoconstriction -(AT1 receptor blockers would prevent this action) |
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