(First Aid) Renal (Pharmacology)

30 terms by adamkdeal 

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Mannitol

Osmotic diuretic that increases urine flow by increasing tubular fluid osmolarity and drawing out water in the porixmal tubule and descending loop

Anuria and CHF

When are the contraindications for Mannitol

Acetozolamide

Carbonic anhydrase inhibitor that causes self-limited NaHCO3 diuresis.

Hyperchloremic metabolic acidosis (ACIDazolamide causes ACIDosis), inc NH3, sulfa aleergy

What are the 3 potentially bad side effects of acetazolamide

Furosemide (Loop diuretic)

Inhibitor of Na/K/2Cl symporter in thick ascending loop. Makes medulla less hypertonic so urine can't be concentrated.

Ca (Loops lose calcium - because lumen is less positive so it doesn't drive Ca and Mg resoprtion)

What ion does furosemide make you lose?

OH DANG! (Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa) Nephritis (interstitial), Gout)

What is the mnemonic for the side effects of furosemide?

Ethacrynic acid (loop diuretic but not a sulfa)

What do you substitute for furosemide in your patient with a sulfa allergy or that has gout?

Hydroclorothiazide (thiazides)

Inhibits NaCl reabsorption in early distal tubule. Causes reduced diluting capacity. Don't give to sulfa allergy patients

Ca (dec excretion)

Hydroclorothiazide causes increased amounts of what ion to build up?

HyperGLUC (Hypokalemic metabolic alkalosis, hyponatremia, hyperGlycemia, hyperLipidemia, hyperUricemia, and hyperCalcemia)

Mnemonic for side effects of Hydrochlorothiazide

Spironalactone and Eplerenone

Competitive aldosterone receptor antagonists in cortical collecting tubule. Blocks loss of K+ (2)

Triamterone, Amiloride

K sparing diuretic that blocks Na+ channels in the cortical collecting tubule.

The K+ STAys (K+, spironalactone, Triamterone, Amiloride)

Mnemonic for remembering the K+ sparing diuretics' names

Hyperkalemia, Endocrine effects (gynecomastia, antiandrogen, etc)

Side effects for K sparing diuretics

All diuretics (including CA inhibitors)

Which diuretics inc urine NaCl

All (except K+ sparing)

What diuretics increase urine K+

CA inhibitors, K+ sparing diuretics

Which diuretics make your blood more acidic (dec pH)?

Loop diuretics and thiazides

Which diuretics make your blood more alkalotic (inc pH)?

Loop diuretics

Which diuretics inc urine calcium (dec plasma calcium)?

Thiazides

Which diuretics dec urine calcium (inc blood calcium)?

-prils (captopril, enalapril, lisinopril)

ACE inhibitors that dec angiontensin II and prevent bradykinin inactivation (leads to vasodilation). Will se increased renin levels in blood (loss of feedbackinhibition)

Losartan (no cough)

Angiotensin II receptor antagonist

Cough, Feta l renal damage, Hyperkalemia (avoid with bilateral renal artery stenosis)

What are the side effects of ACE inhibitors (3)?

ADH antagonists

Diuretics that inhibit V2 ADH receptor by blocking AQP insertion in the collecting duct

Demeclocine (bone/teeth abnormalities), lithium (nephrogenic diabetes insipidus)

ADH antagonists

Ca inhibitors (NaHCo3 inc is key)

Diuretic that causes urinary: NaCl (inc), NaHCO3 (inc), K+ (inc) Ca (inc), Body pH (dec)

Loop diuretics

Diuretic that causes urinary: NaCl (inc - biggest), dec NaHCo3, K+ (inc, Ca (inc), Body pH (inc)

Thiazides (dec Ca is key)

Diuretic that causes urinary: NaCl (inc), K+ (inc), Ca (dec), body pH (inc, no change in urinary excretion of NaHCO3)

K+ sparing diuretcs (dec K is key)

Diuretic that causes urinary: NaCL (inc), K+ (dec), no change in Ca or K, and body pH (dec)

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