Pharmacology of Diuretics and Opioid Antagonists

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Questions and Answers

Which of the following medications works by reducing glucose reabsorption in the kidneys?

  • Dapagliflozin (correct)
  • Spironolactone
  • Frusemide
  • Erythropoietin

A patient with chronic renal failure is experiencing anemia. Which of the following would be most suitable to address this specific issue?

  • Potassium
  • Erythropoietin (correct)
  • Hydrochlorothiazide
  • Albumin

Which type of intravenous solution is most appropriate for a patient experiencing cellular dehydration?

  • 5% Dextrose
  • 0.9% Normal Saline
  • 10% Dextrose (correct)
  • 4.5% N/S

A patient is prescribed a medication that blocks sodium reabsorption in the loop of Henle. Which diuretic is most likely being used?

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

Which of the following best describes the mechanism of action of albumin when administered intravenously?

<p>Increases osmotic pressure, retaining fluid within the blood vessels. (D)</p> Signup and view all the answers

Which medication is a dopamine precursor utilized in the treatment of Parkinson's disease?

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

A patient with a suspected opioid overdose has been administered naloxone. Which response would be expected given the mechanism of action of this medication?

<p>Reversal of respiratory depression due to blockage of opioid receptors (A)</p> Signup and view all the answers

What is a common mechanism of action of phenytoin, carbamazepine, and lamotrigine?

<p>Modulating sodium channels (D)</p> Signup and view all the answers

Which of the following best describes the primary action of lactulose?

<p>Prevents ammonia absorption and softens stools. (A)</p> Signup and view all the answers

A patient with type 2 diabetes is prescribed metformin. What is the primary mechanism by which this medication helps to manage blood glucose levels?

<p>Reducing liver glucose production and increasing insulin sensitivity (C)</p> Signup and view all the answers

A patient is experiencing seizures and is prescribed Midazolam. What is the primary action of this medication that makes it effective for this purpose?

<p>Acting on GABA_A receptors (D)</p> Signup and view all the answers

Which combination of medications directly reduces the production of gastric acid?

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

What is a potential adverse effect of mannitol that needs to be carefully monitored?

<p>Fluid leaking back into interstitial spaces (C)</p> Signup and view all the answers

Flashcards

What is a SGLT2 inhibitor like Dapagliflozin used for?

A medication that helps lower blood sugar by preventing the kidneys from reabsorbing glucose back into the bloodstream.

What is a loop diuretic like Frusemide known for?

A type of diuretic that works in the loop of Henle, preventing sodium reabsorption and increasing urine production.

What does Erythropoietin do?

A hormone produced by the kidneys that stimulates the production of red blood cells.

What is Mannitol?

A drug that reduces intracranial pressure by altering osmosis, drawing water out of the brain. Often used in cases of cerebral edema.

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What are Crystalloid solutions like NS 0.9% and CSL used for?

A type of solution that has the same osmolarity as blood, meaning it won't cause fluid to shift between blood vessels and cells.

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What is Naloxone?

Blocks the effects of opioids at the mu opioid receptor by preventing G protein coupling, reversing opioid overdose.

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What happens when Hypotonic solutions like 10% Dextrose are administered?

A type of solution that has a lower osmolarity than blood, causing water to move into cells.

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What are Anti-Seizure Medications?

A class of drugs that increase the activity of GABA, an inhibitory neurotransmitter, which reduces nerve excitability and helps control seizures. Examples include Valproate, Phenobarbital, Phenytoin, Carbamazepine, Gabapentin, and Lamotrigine.

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What is Levodopa?

A precursor to dopamine that converts to dopamine in the brain and is used to treat Parkinson's disease.

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What is Midazolam?

A sedative that acts on GABA A receptors in the brain, leading to a calming effect. It's used for managing seizures and in anesthesia.

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What are Histamine 2 Blockers?

Antagonists of the histamine H2 receptor, which decreases gastric acid production. They are often used to treat gastric ulcers, heartburn, and GERD.

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What is Loperamide?

A drug that activates opioid receptors in the gut, slowing down bowel movements and reducing stool frequency. It's used to treat diarrhea.

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What are Proton Pump Inhibitors?

A type of drug that inhibits the enzyme in the stomach responsible for producing acid, thereby reducing stomach acid production. They are often used to treat ulcers, GERD, and other conditions related to excessive stomach acid.

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Study Notes

Diuretics

  • Mechanism (Mannitol): Alters osmosis, reducing water volume and intracranial pressure (ICP).
  • Indications (Mannitol): Cerebral edema, increased ocular pressure.
  • Adverse Effects (Mannitol): Risk of fluid leaking back into interstitial spaces, potentially worsening cerebral edema.
  • Mechanism (Loop Diuretic - Frusemide): Blocks sodium reabsorption in the loop of Henle.
  • Mechanism (Thiazide - Hydrochlorothiazide): Acts in the distal tubule, depleting potassium.
  • Mechanism (Potassium-Sparing - Spironolactone): Counteracts potassium loss.
  • Indications (Diuretics): Hypertension, chronic renal failure.

Opioid Antagonist

  • Mechanism (Naloxone): Blocks opioid effects at mu opioid receptors, preventing G protein coupling.
  • Indications (Naloxone): Opioid overdose.
  • Other Considerations (Naloxone): Quick onset, short-acting; requires repeated dosing.

Anti-Seizure Medications

  • Sodium Valproate (Epilim): Increases GABA, blocks sodium channels. Used for seizures, epilepsy, and mania.
  • Phenobarbital (Barbital): Enhances GABA action, reduces seizure spread. Indicated for epilepsy and sedation.
  • Phenytoin (Dilantin): Modulates sodium channels, stabilizing nerve excitability. Used in tonic-clonic seizures and post-surgery.
  • Carbamazepine: Reduces nerve impulses, treating seizures, nerve pain, schizophrenia, and bipolar disorder.
  • Gabapentin: Blocks nerve signals, treats seizures and nerve pain. Risk of dependence and suicidal thoughts.
  • Lamotrigine: Modulates sodium channels, reduces glutamate release. Treats seizures, nerve pain, and bipolar disorder.

Dopamine Precursor and Decarboxylase Inhibitor

  • Levodopa (Sinemet): Converts to dopamine in the brain, used for Parkinson's disease.
  • Carbidopa: Inhibits peripheral conversion of levodopa.

Sedative

  • Mechanism (Midazolam): Acts on GABA A receptors, calming the brain.
  • Indications (Midazolam): Seizures, anesthesia.

Gastrointestinal (GIT) Medications

  • Histamine 2 Blockers (Ranitidine, Famotidine): H2 receptor antagonists inhibit gastric acid production.
  • Indications (Histamine 2 Blockers): Gastric ulcers, heartburn, GERD.
  • Anti-Diarrheal (Loperamide): Activates opioid receptors in the gut, reducing stool frequency.
  • Indications (Anti-Diarrheal): Diarrhea.
  • Proton Pump Inhibitors (Pantoprazole): Suppresses gastric acid secretion.
  • Indications (Proton Pump Inhibitors): GI lesions, ulcers, GERD.
  • Laxative (Lactulose): Prevents ammonia absorption, softens stools.
  • Indications (Lactulose): Hepatic encephalopathy, stool softening.

Endocrine Medications

  • Insulin (Short-Acting): Actrapid, Novorapid
  • Insulin (Long-Acting): Solostar, Optisulin
  • Mechanism (Insulin): Regulates glucose metabolism, lowers blood glucose levels (BGL).
  • Indications (Insulin): Type 1 and Type 2 diabetes mellitus (T1DM, T2DM).
  • Biguanide (Metformin): Reduces liver glucose production, increases insulin sensitivity.
  • Indications (Biguanide): First-line treatment for T2DM.
  • Sulfonylureas (Glipizide): Increases insulin secretion.
  • Indications (Sulfonylureas): Adjunct for T2DM.
  • SGLT2 Inhibitor (Dapagliflozin): Reduces glucose reabsorption in kidneys.
  • Indications (SGLT2 Inhibitor): T2DM, weight loss, fluid management.

Renal Medications

  • Hormone (Erythropoietin): Stimulates RBC production.
  • Indications (Erythropoietin): Anemia in chronic renal failure or cancer.
  • Vitamin D: Increases calcium and phosphate absorption.
  • Indications (Vitamin D): Vitamin D and calcium deficiency.
  • Colloid (Albumin): Increases osmotic pressure, retains fluid intravascularly.
  • Indications (Colloid): Fluid resuscitation, shock, rehydration.

Electrolytes and Fluids

  • Electrolyte (Potassium): Maintains muscle and nerve function.
  • Indications (Potassium): Potassium deficiency.
  • Crystalloid Solutions (NS 0.9%, CSL, Dex5%): Match osmolarity of blood, no fluid shifts.
  • Indications (Crystalloid Solutions): Fluid resuscitation, shock.
  • Hypotonic Solutions (10% Dextrose, 50% Dextrose): Move water into cells.
  • Indications (Hypotonic Solutions): Hyponatremia, cellular dehydration.
  • Hypertonic Solutions (0.45% N/S): Move water out of cells.
  • Indications (Hypertonic Solutions): Hypernatremia, reduce intracranial pressure.

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