Pharmacology Chapter 2.1
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Questions and Answers

What is a primary clinical manifestation of Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH)?

  • Dehydration
  • Hypernatremia
  • Lethargy (correct)
  • Hypertension

    • Which of the following conditions can induce Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH)?

  • Infections in the CNS (correct)
  • Diabetes insipidus
  • Coronary artery disease
  • Chronic kidney disease

    • Which treatment option is commonly used for managing Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH)?

  • Intravenous administration of isotonic saline
  • Loop diuretics (correct)
  • Exercise therapy
  • Increased water intake

    • What type of medications are known to potentially induce SIADH?

    <p>Selective serotonin reuptake inhibitors (D)</p> Signup and view all the answers

    Which of the following is a characteristic feature of SIADH?

    <p>Hyponatremia (A)</p> Signup and view all the answers

    What is an appropriate use of vasopressin?

    <p>Postoperative ileus and abdominal distension (B)</p> Signup and view all the answers

    Desmopressin is specifically indicated for which of the following conditions?

    <p>Central diabetes insipidus (D)</p> Signup and view all the answers

    Which vasopressin antagonist is administered intravenously?

    <p>Conivaptan (A)</p> Signup and view all the answers

    What is a significant adverse effect associated with tolvaptan?

    <p>Hepatotoxicity (D)</p> Signup and view all the answers

    Which condition is NOT a use for desmopressin?

    <p>Burn wound excision (C)</p> Signup and view all the answers

    What mechanism of action does conivaptan have?

    <p>Blockade of both V1a and V2 receptors (D)</p> Signup and view all the answers

    Which of the following is a contraindication for vasopressin agonists?

    <p>Patients with coronary artery disease (C)</p> Signup and view all the answers

    Which side effect is commonly associated with vasopressin agonists?

    <p>Water intoxication (C)</p> Signup and view all the answers

    Which of the following is NOT a use for carbonic anhydrase inhibitors?

    <p>Treatment of AKI (C)</p> Signup and view all the answers

    What is the primary site of action for osmotic diuretics?

    <p>Proximal convoluted tubule and Loop of Henle (D)</p> Signup and view all the answers

    What adverse effect is associated with carbonic anhydrase inhibitors?

    <p>Drowsiness (C)</p> Signup and view all the answers

    Which loop diuretic is a phenoxyacetic acid derivative?

    <p>Ethacrynic acid (A)</p> Signup and view all the answers

    What mechanism do loop diuretics primarily utilize?

    <p>Inhibit Na+-K+-2Cl− symporter (C)</p> Signup and view all the answers

    Which of the following conditions is a contraindication for the use of osmotic diuretics?

    <p>Anuria (B)</p> Signup and view all the answers

    Which of the following is a potential adverse effect of osmotic diuretics?

    <p>Florid pulmonary edema (B)</p> Signup and view all the answers

    What is the primary result of carbonic anhydrase inhibitors on bicarbonate reabsorption?

    <p>Decreased reabsorption (B)</p> Signup and view all the answers

    Which drug class is not typically associated with increasing the effectiveness of thiazides?

    <p>Uricosuric agents (D)</p> Signup and view all the answers

    What is a common side effect of potassium-sparing diuretics like Triamterene?

    <p>Hyperkalemia (D)</p> Signup and view all the answers

    Which condition is Amiloride primarily used to treat?

    <p>Liddle syndrome (D)</p> Signup and view all the answers

    What is a potential adverse effect associated with Spironolactone?

    <p>Gynecomastia (B)</p> Signup and view all the answers

    Which of the following drugs can increase the risk of hypokalemia when administered with thiazides?

    <p>Amphotericin B (D)</p> Signup and view all the answers

    What type of diuretic primarily acts at the collecting tubule?

    <p>Potassium-sparing diuretics (C)</p> Signup and view all the answers

    Eplerenone and Finerenone are types of which diuretic class?

    <p>Aldosterone antagonists (C)</p> Signup and view all the answers

    Which medication should be avoided in patients with a creatinine clearance of ≤ 30 mL/min?

    <p>Eplerenone (C)</p> Signup and view all the answers

    What is a primary use of loop diuretics?

    <p>Acute pulmonary edema (D)</p> Signup and view all the answers

    Which adverse effect is most commonly associated with the use of loop diuretics?

    <p>Ototoxicity (B)</p> Signup and view all the answers

    Which of the following is a contraindication for the use of loop diuretics?

    <p>Postmenopausal women (A)</p> Signup and view all the answers

    What is a common drug interaction with loop diuretics?

    <p>Increased ototoxicity with aminoglycosides (D)</p> Signup and view all the answers

    What is the primary site of action for thiazide diuretics?

    <p>Distal convoluted tubule (B)</p> Signup and view all the answers

    Which of the following is an adverse effect associated with thiazide diuretics?

    <p>Hyperuricemia (A)</p> Signup and view all the answers

    What condition is considered a therapeutic use of thiazide diuretics?

    <p>Nephrolithiasis due to idiopathic hypercalciuria (D)</p> Signup and view all the answers

    Which mechanism do thiazide diuretics use to decrease sodium reabsorption?

    <p>Blocking Na+/Cl− transporter (A)</p> Signup and view all the answers

    What is the primary use of Mirabegron?

    <p>To prevent voiding in urinary incontinence (A)</p> Signup and view all the answers

    Which of the following is a characteristic of beta-adrenergic receptor antagonists?

    <p>They include non-selective and selective beta-blockers (A)</p> Signup and view all the answers

    What does diuretic braking refer to?

    <p>Compensatory mechanisms that stabilize sodium excretion (A)</p> Signup and view all the answers

    Which agent is considered the prototype beta-blocker?

    <p>Propranolol (A)</p> Signup and view all the answers

    Which of the following statements about diuretics is accurate?

    <p>Diuretics can trigger compensatory mechanisms in the body (B)</p> Signup and view all the answers

    Which mechanism is involved in diuretic braking?

    <p>Increased sympathetic nervous system activity (C)</p> Signup and view all the answers

    What is one of the functions of Beta 3 selective agonists like Vibegron?

    <p>To prevent urinary incontinence (B)</p> Signup and view all the answers

    Which of the following beta-blockers is most cardioselective?

    <p>Nebivolol (B)</p> Signup and view all the answers

    Study Notes

    Pharmacology 2.1 Outline

    • This presentation covers adrenergic agonists and antagonists, drugs acting in the renal system, and water homeostasis and the vasopressin system.

    I. Adrenergic Agonists and Antagonists

    • A. Adrenergic Receptors
      • Alpha 1: vasoconstriction, increased blood pressure, mydriasis, and closure of bladder sphincter
      • Alpha 2: controls NE release, inhibits Ach and insulin release, and provides feedback inhibition
      • Beta 1: increased heart rate, increased myocardial contractility, increased release of renin, and closure of bladder sphincter
      • Beta 2: vasodilation, decreased peripheral resistance, bronchodilation, glycogenolysis, and uterine relaxation
      • Beta 3: lipolysis
    • B. Adrenergic Agonists
      • Phenylephrine: activates beta receptors at higher concentrations, used as a nasal decongestant and mydriatic
      • Midodrine: prodrug (desglymidodrine), treats autonomic insufficiency and postural hypotension, and can cause supine hypertension
      • Metaramine: acts directly on vascular alpha receptors, acts indirectly through stimulation of NE release, and used to treat hypotensive states
      • Clonidine: transient vasoconstriction, uses for hypertensive urgency, common off-label uses in diarrhea in DM patients, treatment and preparation for withdrawal from narcotics, alcohol, and tobacco
      • Alpha 1 selective agonists
      • Alpha 2 selective agonists
      • Nonselective beta agonists: Isoproterenol, and Dobutamine
    • C. Adrenergic Antagonists
      • alpha receptor antagonists: phenoxybenzamine, phentolamine, prazosin, terazosin, doxazosin, alfuzosin, tamsulosin, indoramin, urapidil, and bunazosin
      • beta receptor antagonists: Propranolol, nadolol, atenolol, metoprolol, bisoprolol, celiprolol, carvedilol, labetalol, timolol, etc.. (A table listing varieties available is mentioned in the text)

    II. Drugs Acting in the Renal System

    • A. Diuretics
      • Carbonic Anhydrase Inhibitors: acetazolamide, dorzolamide, dichlorphenamide, and methazolamide. These drugs inhibit carbonic anhydrase, leading to nearly complete abolition of NaHCO3 reabsorption in the proximal tubule.
      • Osmotic Diuretics: glycerin, isosorbide, mannitol, and urea. They limit osmosis in the interstitial space, reducing luminal Na+ concentration.
      • Loop Diuretics: furosemide, bumetanide, ethacrynic acid, and torsemide. These inhibit Na+-K+-2Cl- symporter in the thick ascending loop of Henle.
      • Thiazide and Thiazide-like Diuretics: hydrochlorothiazide (HCTZ), chlorothiazide, bendroflumethiazide, methyclothiazide, chlorthalidone, indapamide, and metolazone.
    • B. SGLT2 Inhibitors
      • Dapagliflozin
      • Canagliflozin
      • Empagliflozin
      • Ipragliflozin
    • C. Natriuretic Peptides
      • ANP, BNP, CNP, urodilatin (similar to ANP)
      • Nesiritide, Carperitide, Ularitide
      • Sacubitril (combined with ARB valsartan)
    • D. Adenosine Receptor Antagonists
      • Methylxanthines: caffeine, theophylline, and theobromine
      • Pamabrom

    III. Water Homeostasis and the Vasopressin System

    • A. Vasopressin Physiology
      • Vasopressin/arginine vasopressin (AVP), also known as antidiuretic hormone (ADH). Released by posterior pituitary gland, regulates body fluid osmolality.
      • Drugs that stimulate vasopressin secretion: vincristine, cyclophosphamide, tricyclic antidepressants, nicotine, epinephrine, lithium, and high doses of morphine
      • Drugs that inhibit vasopressin secretion: ethanol, phenytoin, low doses of morphine, glucocorticoids, gluphenazine, haloperidol, promethazine, oxilorphan, butorphanol, and carbamazepine
      • AVP receptors (types V1a, V1b, V2, and V3/V1b) locations and actions with AVP binding.
      • Table of naturally occurring vasopressin-like peptides and synthetic vasopressin peptides.
    • B. Vasopressin Receptor Agonists
    • C. Diseases Affecting the Vasopressin System
      • Diabetes Insipidus (DI) (Central and Nephrogenic)
      • Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH)
    • D. Clinical Use of Vasopressin Agonists (V1 and V2 recepto mediated).
    • E. Clinical Use of Vasopressin Antagonists.

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    Pharmacology 2.1 PDF by NAC, RPh

    Description

    This quiz covers key concepts from Pharmacology Chapter 2.1, focusing on adrenergic agonists, antagonists, and their effects on the renal system and water homeostasis. Test your understanding of adrenergic receptors and their roles in various physiological processes.

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