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Pharmacology 5334 Module 5 Exam Questions And Accurate Answers
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Pharmacology 5334 Module 5 Exam Questions AndAccurate Answers 2024-2025
Cardiac output-Answer Average adult: 5 L/minute; heart rate X stroke volume; HR
controlled by the ANS; SV: myocardial contractility, cardiac afterload, cardiac preload
Preload - Answer The end-diastolic volume/pressure represents the tension applied to a
muscle just before contraction. Stroke volume increases if preload increases and stroke
volume decreases if it decreases.
Afterload - Answer The arterial pressure that the left ventricle must overcome to eject
blood. When afterload increases, stroke volume decreases - and vice versa.
Basic functions of diuretics - Answer Purification of ECF and maintenance of ECF
volume and composition; maintenance of acid-base balance; excretion of metabolic
wastes and foreign substances
Three basic renal processes: Filtration occurs in the glomerulus, and reabsorption of
99% of water, electrolytes, and nutrients occurs at the glomerulus; active tubular
secretion occurs in the proximal convoluted tubule. One pumps organic acids; one
pumps bases.
Mechanism of Action of Diuretics: Blockade of sodium and chloride reabsorption; site of
action: proximal tubule, producing greatest diuresis. Adverse effects: hypovolemia,
acid-base imbalance, electrolyte imbalance
Four major classes of diuretics - Loops: furosemide; Thiazide: hydrochlorothiazide;
osmotic: mannitol; potassiumsparing: aldosterone antagonists (spironolactone) and
non-aldosterone antagonists (triamterene); carbonic anhydrase inhibitors
Furosemide (Lasix) - Looped Most frequently prescribed loop diuretic. MOA: acts on
,ascending loop of Henle to block reabsorption. Pharmacokinetics: rapid onset (PO 60
min; IV 5 min); short half life (6 hours). Therapeutic uses: pulmonary edema, edematous
states, HTN
Furosemide side effects - Answer Hyponatremia, hypochloremia, and dehydration;
hypotension; hypokalemia; ototoxicity
Furosemide drug interactions - Answer Digoxin, ototoxic drugs, potassium-sparing
diuretics, lithium, antihypertensive agents, NSAIDs
Other loop diuretics - Answer Ethacrynic acid, Bumetanide, Torsemide. All can cause:
ototoxicity, hypovolemia, hypotension, hypokalemia, hyperuricemia, hyperglycemia, and
disruption of lipid metabolism
Thiazide Diuretics (benzothiazides) - Answer Effects similar to those of loop diuretics:
increase renal excretion of sodium, chloride, potassium, and water; elevate levels of
uric acid and glucose. Maximum diuresis is considerably lower than with loop diuretics.
Not effective when urine flow is scant.
Hydrochlorothiazide - Answer Most widely used thiazide diuretic. Action: early segment
distal convoluted tubule. Peaks in 4-6 hours. Therapeutic uses: essential HTN, edema,
diabetes insipidus
HCTZ side effects - Answer Hyponatremia, hypochloremia, and dehydration;
hypokalemia; hyperglycemia; hyperuricemia
HCTZ drug interactions - Answer Digoxin; increases effects of hypertensive
medications; may decrease renal excretion of lithium (resulting in accumulation of
lithium); NSAIDs may diminish diuretic response; can be used with ototoxic agents
without risk of ototoxicity
Potassium-sparing diuretics - Useful responses: modest increase in urine production
and considerable reduction in potassium excretion. Seldom used alone for therapy.
Aldosterone antagonist: spironolactone. Non-aldosterone antagonists: triamterene and
, amiloride
Spironolactone - MOA: blocks aldosterone in the distal nephron; results in retention of
potassium; increased excretion of sodium. Uses: HTN, edematous states, HF, primary
hyperaldosteronism, premenstrual syndrome, PCOS, acne in young women, hirsutism
Spironolactone side effects Discussion Hyperkalemia, benign and malignant tumors,
endocrine effects. Drug interactions: thiazide and loop diuretics; agents that increase
potassium levels
Triamterene Discussion MOA: inhibits sodium-potassium exchange in the distal
nephron; acts as a direct inhibitor of the exchange mechanism; reduces sodium
reuptake; inhibits ion transport. Clinical uses: HTN, edema
Triamterene side effects Discussion Hyperkalemia, leg cramps, N/V, dizziness, blood
dycrasias
Amiloride - Answer MOA: inhibits sodium-potassium exchange in the distal nephron.
Use: opposes potassium loss induced by more potent diuretics. Adverse effects:
hyperkalemia. Drug interactions: ACE inhibitors; other drugs causing hyperkalemia.
Mannitol - Answer Osmotic diuretic. Induces diuresis by exerting osmotic pressure
within the lumen of the nephron. Must be administered IM/IV. Uses: prevention of renal
failure; decrease in intracranial and intraocular pressure.
Mannitol side effects Answer Edema, headache, nausea, vomiting, fluid and electrolyte
imbalance
Actions of aldosterone - Answer Regulation of blood volume and blood pressure; helps
with pathologic CV effects
ACE Inhibitors-Answer Regulation of BP via the RAAS; helps maintain BP during
hemorrhage, dehydration or sodium depletion. Acts by: contraction of renal blood
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