Podcast
Questions and Answers
Which type of diuretic is first-line for Acute pulmonary edema?
Which type of diuretic is first-line for Acute pulmonary edema?
- Loop diuretics (correct)
- Thiazide diuretics
- Carbonic Anhydrase Inhibitors
- Potassium-sparing diuretics
What is the mechanism of action of Carbonic Anhydrase Inhibitors (CAIs)?
What is the mechanism of action of Carbonic Anhydrase Inhibitors (CAIs)?
- Enhancement of potassium excretion
- Inhibition of Na+ reabsorption in the thick ascending limb
- Blockade of bicarbonate absorption (correct)
- Inhibition of carbonic anhydrase enzyme
Which diuretic interacts with Aminoglycosides?
Which diuretic interacts with Aminoglycosides?
- Loop diuretics (correct)
- Potassium-sparing diuretics
- Carbonic Anhydrase Inhibitors
- Thiazide diuretics
Why are Loop diuretics not considered first-line diuretics in general?
Why are Loop diuretics not considered first-line diuretics in general?
Which condition is Carbonic Anhydrase Inhibitors (CAIs) commonly used to treat?
Which condition is Carbonic Anhydrase Inhibitors (CAIs) commonly used to treat?
Which diuretic is indicated for the treatment of altitude sickness?
Which diuretic is indicated for the treatment of altitude sickness?
Why are Loop diuretics not commonly considered first-line diuretics?
Why are Loop diuretics not commonly considered first-line diuretics?
Which diuretic is preferred when there is a concern about Creatinine Clearance (CrCl)?
Which diuretic is preferred when there is a concern about Creatinine Clearance (CrCl)?
Inhibiting which transporter is the primary mechanism of Loop diuretics?
Inhibiting which transporter is the primary mechanism of Loop diuretics?
Which type of diuretic is specifically recommended as first-line for Acute pulmonary edema?
Which type of diuretic is specifically recommended as first-line for Acute pulmonary edema?
Which medication is known to cause cough as a side effect?
Which medication is known to cause cough as a side effect?
Which class of medications blocks the binding of Angiotensin II to its receptor?
Which class of medications blocks the binding of Angiotensin II to its receptor?
Which medication is specifically mentioned as the DOC (drug of choice) for pre-eclampsia?
Which medication is specifically mentioned as the DOC (drug of choice) for pre-eclampsia?
Which group of medications inhibits the release of neurotransmitters into the synaptic cleft?
Which group of medications inhibits the release of neurotransmitters into the synaptic cleft?
Which type of Ca2+ channels are inhibited by Dihydropyridines?
Which type of Ca2+ channels are inhibited by Dihydropyridines?
Which medication inhibits VMAT-2, preventing vesicle turnover and depleting norepinephrine?
Which medication inhibits VMAT-2, preventing vesicle turnover and depleting norepinephrine?
Which medication is NOT an ACE Inhibitor or an ARB but can still be used in pregnancy?
Which medication is NOT an ACE Inhibitor or an ARB but can still be used in pregnancy?
What lifestyle modification is recommended for individuals with hypertension in terms of alcohol consumption?
What lifestyle modification is recommended for individuals with hypertension in terms of alcohol consumption?
Which medication can exacerbate congestive heart failure and must be always given with a beta-blocker and diuretic?
Which medication can exacerbate congestive heart failure and must be always given with a beta-blocker and diuretic?
What is the approximate reduction in systolic blood pressure (SBP) associated with a weight loss of 10kg?
What is the approximate reduction in systolic blood pressure (SBP) associated with a weight loss of 10kg?
Which lifestyle modification is recommended in terms of dietary sodium intake for individuals with hypertension?
Which lifestyle modification is recommended in terms of dietary sodium intake for individuals with hypertension?
Which lab value range falls within the normal reference range for Potassium?
Which lab value range falls within the normal reference range for Potassium?
What type of drug must always be given with a beta-blocker and diuretic to prevent certain adverse effects?
What type of drug must always be given with a beta-blocker and diuretic to prevent certain adverse effects?
'Olol' is a commonly used suffix for medications belonging to which class of drugs?
'Olol' is a commonly used suffix for medications belonging to which class of drugs?
Which ACEI is a prodrug hydrolyzed by hepatic esterases to its active metabolite Enalaprilat?
Which ACEI is a prodrug hydrolyzed by hepatic esterases to its active metabolite Enalaprilat?
Which ACEI is structurally similar to Enalapril and can be formulated as an oral solution called Qbrelis?
Which ACEI is structurally similar to Enalapril and can be formulated as an oral solution called Qbrelis?
Which ACEI is the third one approved for use in the U.S.?
Which ACEI is the third one approved for use in the U.S.?
What effect does food have on the bioavailability of Lisinopril?
What effect does food have on the bioavailability of Lisinopril?
In which hypertensive state should ACEIs be avoided according to the provided text?
In which hypertensive state should ACEIs be avoided according to the provided text?
What are the potential compensatory reflexes associated with Low dose of Organic Nitrates?
What are the potential compensatory reflexes associated with Low dose of Organic Nitrates?
Which adverse effect is NOT commonly associated with excessive hypotension from Organic Nitrates?
Which adverse effect is NOT commonly associated with excessive hypotension from Organic Nitrates?
What is the primary mechanism of action of Minoxidil as a K+ Channel Opener?
What is the primary mechanism of action of Minoxidil as a K+ Channel Opener?
Which effect is NOT associated with Minoxidil use in severe resistant hypertension?
Which effect is NOT associated with Minoxidil use in severe resistant hypertension?
What is the primary concern when using Minoxidil due to its vasodilator effects?
What is the primary concern when using Minoxidil due to its vasodilator effects?
Minoxidil is contraindicated in patients with which of the following conditions?
Minoxidil is contraindicated in patients with which of the following conditions?
Minoxidil, similar to which medication, can cause reflex tachycardia requiring the use of β-blockers?
Minoxidil, similar to which medication, can cause reflex tachycardia requiring the use of β-blockers?
Minoxidil use is cautioned in patients with which specific tumor?
Minoxidil use is cautioned in patients with which specific tumor?
Which receptors are involved in Angiotensin-II mediated biological effects?
Which receptors are involved in Angiotensin-II mediated biological effects?
What is a potential functional role of AT2 receptors?
What is a potential functional role of AT2 receptors?
Which receptors are primarily associated with preeclampsia?
Which receptors are primarily associated with preeclampsia?
Which class of medications includes ACE inhibitors?
Which class of medications includes ACE inhibitors?
Which CCB is contraindicated in patients with egg or soy allergy, severe aortic stenosis, or defective lipid metabolism?
Which CCB is contraindicated in patients with egg or soy allergy, severe aortic stenosis, or defective lipid metabolism?
What should be the alternative choice of calcium channel blocker for a patient on carbamazepine, phenobarbital, phenytoin, rifampin, or St. John’s wort due to significant drug interactions?
What should be the alternative choice of calcium channel blocker for a patient on carbamazepine, phenobarbital, phenytoin, rifampin, or St. John’s wort due to significant drug interactions?
Which calcium channel blocker is recommended as the drug of choice for hypertensive pre-eclampsia or eclampsia during pregnancy?
Which calcium channel blocker is recommended as the drug of choice for hypertensive pre-eclampsia or eclampsia during pregnancy?
Which medication should always be given with a beta-blocker when used concurrently due to potential interactions?
Which medication should always be given with a beta-blocker when used concurrently due to potential interactions?
Which calcium channel blocker should not be used for acute blood pressure reduction?
Which calcium channel blocker should not be used for acute blood pressure reduction?
What is the mechanism of action of centrally acting α2 adrenergic agonists like clonidine and methyldopa?
What is the mechanism of action of centrally acting α2 adrenergic agonists like clonidine and methyldopa?
What rare side effect is associated with Clevidipine?
What rare side effect is associated with Clevidipine?
What category is Nifedipine in pregnancy?
What category is Nifedipine in pregnancy?
In African Americans, which class of antihypertensive medications shows reduced blood pressure responses compared to others?
In African Americans, which class of antihypertensive medications shows reduced blood pressure responses compared to others?
For patients with Left Ventricular Systolic Dysfunction (LVSD), what is the recommended approach regarding ACE Inhibitors?
For patients with Left Ventricular Systolic Dysfunction (LVSD), what is the recommended approach regarding ACE Inhibitors?
Which medication class is particularly useful in patients with Myocardial Infarction (MI) and coexisting hypertension and/or diabetes according to quality clinical studies?
Which medication class is particularly useful in patients with Myocardial Infarction (MI) and coexisting hypertension and/or diabetes according to quality clinical studies?
What is a contraindication related to the use of ACE Inhibitors in patients with Acute MI?
What is a contraindication related to the use of ACE Inhibitors in patients with Acute MI?
In which group of patients do ACE Inhibitors demonstrate the most effectiveness based on clinical studies like HOPE and EUROPA?
In which group of patients do ACE Inhibitors demonstrate the most effectiveness based on clinical studies like HOPE and EUROPA?
Which combination of antihypertensive drug classes eliminates differential responses observed in African Americans?
Which combination of antihypertensive drug classes eliminates differential responses observed in African Americans?
What should be the immediate action regarding ACE Inhibitors in patients with Acute MI?
What should be the immediate action regarding ACE Inhibitors in patients with Acute MI?
What significant impact do combinations of ACE Inhibitors with other drugs have on African Americans' responses compared to monotherapies?
What significant impact do combinations of ACE Inhibitors with other drugs have on African Americans' responses compared to monotherapies?
Study Notes
Diuretics
- Increase rate of urine flow by increasing rate of Na+ and Cl- excretion
- Carbonic Anhydrase Inhibitors (CAIs) end in -zolamide and are used for glaucoma and altitude sickness
- Block absorption of bicarbonate, which acts as a buffer
- Inhibit Na+ - K+ - 2Cl- symporter in the thick ascending limb
- Not a first-line treatment because they are very potent
- First-line treatment for acute pulmonary edema
- Interacts with Aminoglycosides
- Preferred diuretic when CrCl < 30 mL/min
ACE Inhibitors
- End in -pril
- Good for diabetes, CHF, and acute MI
- Captopril is the only one with a sulfhydryl group
- Inhibits ACE, which increases AT2, which increases IBP
- Side effects: cough, may increase lithium levels, and hyperkalemia
Angiotensin Receptor Blockers (ARBs)
- End in -sartan
- Blocks binding of AT2 to its receptor
- Used if patients get a cough from ACEIs
- Side effect: hyperkalemia
Direct Renin Inhibitors
- Blocks conversion of Angiotensinogen to AngI
- Do not use with ARBs or ACEIs with diabetes or GFR < 60 mL/min
- Example: Aliskiren
Calcium Channel Blockers
- Inhibit L-type Ca2+ channels, which decreases Ca2+ influx in vascular and cardiac cells
- Examples: Dihydropyridines, which end in -dipine
- Vasodilation, decreases PVR
- Effective when combined with β-blockers or diuretics
- CYP3A4 inhibitors: avoid grapefruit
- Interacts with antiarrhythmic drugs
- Nifedipine ER is DOC for pre-eclampsia
Centrally Acting α2 Adrenergic Agonists
- Inhibit release of neurotransmitters into synaptic cleft
- Decrease sympathetic outflow
- Examples: Methyldopa, Clonidine, Guanfacine
- Used in pregnancy
Adrenergic Neuronal Blockers
- Reserpine: inhibits VMAT-2, preventing vesicle turnover, depleting NE
- A- Receptor Antagonists: Doxazosin, Prazosin, Terazosin
- Hypertension and BPH
- Vasodilators: increase water retention
- Hydralazine: CHF exacerbation, must always be given with β-blocker and diuretic
- Nat Nitroprusside: metabolized to cyanide
B-Blockers
- Do not suddenly discontinue treatment
- Masks symptoms of hypoglycemia
- Sexual dysfunction
- Modification
- Physical activity
- Weight management
- DASH diet
- Reduce sodium consumption
- Limit alcohol consumption
- Lifestyle modifications
Lab Values
- Calcium: 8.2-10.2
- Potassium: 3.5-5.0
- Sodium: 136-142
- Chloride: 96-106
- Magnesium: 1.3-2.1
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Description
Test your knowledge on different types of diuretics including Carbonic Anhydrase Inhibitors, Loop Diuretics, and their specific uses and interactions. Learn about these medications that increase urine flow by affecting electrolyte levels in the body.
