Anesthesia Pharmacology Chapter 20: Renal Pharmacology Practice Questions
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Prototype carbonic anhydrase inhibitor:
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furosemide (Lasix)
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bumetanide (Bumex)
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acetazolamide (Diamox)
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triamterene (Dyrenium)
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mannitol
Acetazolamide (Diamox):
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alkaline diuresis
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acid diuresisa
Acetazolamide (Diamox):
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bicarbonate loss
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metabolic alkalosis
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increased cerebrospinal fluid production
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increased aqueous humor production
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all of the above
Clinical applications for carbonic anhydrase inhibitors:
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urinary alkalinization
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metabolic acidosis
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acute mountain sickness
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A & C
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A, B & C
Acetazolamide (Diamox) toxicity:
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renal stones
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renal potassium loss
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hyperchloremic metabolic acidosis
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paresthesias
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all of the above
Pharmacologic antagonism that mineralocorticoid receptors:
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furosemide (Lasix)
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triamterene (Dyrenium)
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spironolactone (Aldactone)
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mannitol
Example(s) of potassium-sparing diuretics:
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chlorothiazide (Diuril)
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torsemide (Demadex)
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triamterene (Dyrenium)
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bumetanide (Bumex)
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acetazolamide (Diamox)
Clinical uses: potassium-sparing diuretics --
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Conn's syndrome
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ectopic ACTH production
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secondary aldosteronism cause by congestive heart failure
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A & C
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A, B & C
Concerning toxicity of triamterene (Dyrenium):
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hypokalemia
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hyperkalemia
Hyperkalemia is less likely when potassium-sparing diuretics are used as the only diuretic drug or the presence of renal insufficiency.
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true
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false
Toxicities/adverse effects of potassium-sparing diuretics:
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hyperchloremic metabolic acidosis
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gynecomastia
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kidney stones
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B & C
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A, B & C
Least likelyto be used clinically today:
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torsemide (Demadex)
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bumetanide (Bumex)
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ethacrynic acid (Edecrin)
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torsemide (Demadex)
Primary site of action of bumetanide (Bumex):
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distal tubule
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collecting duct
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descending loop of Henle
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ascending loop of Henle
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proximal tubule
Most effective diuretic in treatment of acute congestive heart failure -- in terms of magnitude of induced diuresis following IV administration:
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mannitol
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triamterene (Dyrenium)
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bumetanide (Bumex)
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acetazolamide (Diamox)
Major clinical use(s) of loop diuretics:
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management of acute pulmonary edema
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management of acute hypercalcemia
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management of systemic edema
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A & C
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A, B & C
Clinical uses of loop diuretics:
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management of acute hypercalcemia
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management of anion overload
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acute renal failure
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B & C
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A, B & C
Toxicities/toxicity associated with loop diuretics:
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hyperkalemic metabolic acidosis
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ototoxicity
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hypouricemia
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hypermagnesemia
Primary site of action of hydrochlorothiazide (HCTZ, Esidrix, HydroDIURIL):
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thin descending loop of Henle
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thick ascending loop of Henle
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distal convoluted tubule
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proximal tubule
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collecting duct
Thiazide administration will tend to increase uric acid secretion:
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true
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false
Thiazides -- clinical use(s):
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hypertension
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congestive heart failure
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nephrogenic diabetes insipidus
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A & C
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A, B & C
Toxicities/toxicity associated with thiazide diuretics:
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hyperkalemic states
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hypouricemia
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hypolipidemia
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hyponatremia
Diuretic drug classes most commonly used in management of hypertension:
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loop diuretics
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potassium-sparing diuretics
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thiazides
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B & C
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A & C
Least likely to be used initially in the pharmacological treatment of mild hypertension:
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ACE inhibitor
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calcium channel blocker
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beta-blocker
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thiazide
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vasodilator
Clinical use(s) for osmotic diuretics:
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increase urine volume
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decreased intracranial pressure
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both
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neither
Primary treatment of Central (cranial) diabetes insipidus: antidiuretic peptides, e.g. desmopressin {DDAVP}:
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true
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false
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