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Renal & HTN
1. MoA 2. Use 3. Side Effects, 4. Interactions
22
Pharmacology
Professional
03/21/2012

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Cards

Term
acetazolamide
Definition
1. carbonic anhydrase inhibitor; alkalize urine + weak diuresis = distally will increase K excretion
2. glaucoma, metabolic alk, get urin alk, Acute Mountain sickness
3. metabolic acidosis, Ca-renal stones, K wasting; Sulfa Allergy; Contra to Cirrhosis bc decr excretion of ammonium
Term
mannitol
Definition
1. osmotic diuretic, freely filtered
2. give parenterally: decr brain & intraocular pressure
3. first hypoNa and pulm edema, then hyperNa and dehydration
Term
furosemide
Definition
1. loop diuretic, block Na/K/2Cl pump, excrete Ca/Mg
2. hypercalcemia or kalemia, EDEMA, HTN, anion OD
3. post-diuretic Na-retention; ototoxic, Sulfa rxn
4. Aminoglycosides & ototoxic, NSAIDs & uricosurics blut diuresis; very PRO-bound
Term
bumetanide
Definition
1. loop diuretic, block Na/K/2Cl pump, excrete Ca/Mg
2. hypercalcemia or kalemia, EDEMA, HTN, anion OD
3. post-diuretic Na-retention; ototoxic, Sulfa rxn
4. Aminoglycosides & ototoxic, NSAIDs & uricosurics blut diuresis; very PRO-bound
Term
torsemide
Definition
1. loop diuretic, block Na/K/2Cl pump, excrete Ca/Mg
2. hypercalcemia or kalemia, EDEMA, HTN, anion OD
3. post-diuretic Na-retention; ototoxic, Sulfa rxn
4. Aminoglycosides & ototoxic, NSAIDs & uricosurics blut diuresis; very PRO-bound
Term
Na Ethacrynate acid
Definition
1. loop diuretic, block Na/K/2Cl pump, excrete Ca/Mg
2. hypercalcemia or kalemia, EDEMA, HTN, anion OD, No Sulfa Rxn!
3. post-diuretic Na-retention; ototoxic
4. Aminoglycosides & ototoxic, NSAIDs & uricosurics blut diuresis; very PRO-bound
Term
hydrochlorothiazide
Definition
1. distal tube diuretic, block Na/Cl cotransporter & ENHANCE Ca-reabsorption, secreted via OAT proximally
2. HTN, edema, nephrogenic DI, Nephrolithiasis from hyperCa-uric; Osteoporosis
3. hypoK or Na, hyperuricemia, Sulfa Rxn, hyperglycemia/lipidemia
4. AmphoB; NSAIDs & uricosurics blut diuresis
Term
chlorthalidone
Definition
1. distal tube diuretic, block Na/Cl cotransporter & ENHANCE Ca-reabsorption, secreted via OAT proximally
2. HTN, edema, nephrogenic DI, Nephrolithiasis from hyperCa-uric; Osteoporosis
3. hypoK or Na, hyperuricemia, Sulfa Rxn, hyperglycemia/lipidemia
4. AmphoB; NSAIDs & uricosurics blut diuresis
Term
metolazone
Definition
1. distal tube diuretic, block Na/Cl cotransporter & ENHANCE Ca-reabsorption, secreted via OAT proximally
2. HTN, edema, nephrogenic DI, Nephrolithiasis from hyperCa-uric; Osteoporosis
3. hypoK or Na, hyperuricemia, Sulfa Rxn, hyperglycemia/lipidemia
4. AmphoB; NSAIDs & uricosurics blut diuresis
Term
Amiloride
Definition
1. K-sparing diuretic, CCD ENaC inhibitor
2. combo tx; less risk of hypoK metabolic alkalosis
3. hyperCl metabolic alk
Term
triamterine
Definition
1. K-sparing diuretic, CCD ENaC inhibitor
2. combo tx; less risk of hypoK metabolic alkalosis
3. ARF (esp+ indomethacin), Kidney Stones, hyperCl metabolic alk
Term
spironolactone
Definition
1. K-sparing; basolateral aldosterone R antagonist = decr Na in and decr K/H out
2. HF, CIRRHOSIS edema, hyperAldo, mineralcorticoid excess
3. Gynecomastia, impotence from overlap at androgen/progest-R; hyperCl metabolic alk
Term
eplerenone
Definition
1. K-sparing; basolateral aldosterone R antagonist = decr Na in and decr K/H out; more Mineral-R selective
2. hyperAldo, mineralcorticoid excess
3. hyperCl metabolic alk
Term
desmopressin
Definition
1. synthetic vasopressin V2-selective agonist = no vasoconstriction!
(longer 1/2life than endogenous)
2. central DI, coagulopathies of Hemoph A and vWB disease
3. hypoNa
4. lithium = block insertion of aquaporins
Term
conivaptan
Definition
1. vasopressin V1 & V2 antagonist
(lithium would have same effect, tho less predictable)
2. SIADH, CHF
3. HyperNa, nephrogenic DI, ARF
4. lithium
3. many side effects
Term
demeclocycline
Definition
1. vasopressin V1 & V2 antagonist
(lithium would have same effect, tho less predictable)
2. SIADH, CHF
3. HyperNa, nephrogenic DI, ARF
4. lithium
3. many side effects
Term
aliskiren
Definition
1. renin inhibitor; very complete RAAS block w/o incr in bradykinin
2. ACE-i induced cough HTN-pts; great with thiazide
Term
verapamil
Definition
1. inhibit L-type voltage gated Ca++ channels of vascular and cardiac m. = decr PVR
2. HTN
3. AV block, bradycardia, worsen CHF
Term
diltiazem
Definition
1. inhibit L-type voltage gated Ca++ channels of vascular and cardiac m.
2. HTN
3. AV block, bradycardia
Term
nifedipine
Definition
1. inhibit L-type voltage gated Ca++ channels, but more vaso-selective and much less cardiac effects
2. HTN
3. Ankle Edema, tinnitus
Term
captopril
Definition
1. ACE-inhibitor; also blunts Aldo release & is K-sparing
2. HTN with HF/CAD/Chronic renal
3. dry cough and angioedema due to incr bradykinin; Keep watch on RENAL fx; Teratogen
exception - NOT used with renal artery stenosis
Term
candesartan
Definition
1. AngioII-R type1 competitive inhibitor (also blocks Chymase-tissue ACE)
2. no bradykinin cough, less angioedema
3. teratogen, ARF
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