©THEBRIGHT EXAM SOLUTIONS
11/9/2024 2:18 PM
Pharmacology 5334 Module 5 Exam
Questions And Answers 100% Pass
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✔End-diastolic volume/pressure; amount of tension that is applied to a muscle before
contraction; if preload increases, stroke volume increases. If it decreases, stroke volume decreases.
Afterload - answer✔Arterial pressure that the left ventricle must overcome to eject blood; if it increases,
stroke volume decreases, and vice versa.
Basic functions of diuretics - answer✔Cleansing 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 - answer✔Filtration (occurs in the glomerulus); reabsorption (99% of water,
electrolytes, and nutrients undergo reabsorption at the glomerulus); active tubular secretion (occurs in
the proximal convoluted tubule. One pumps organic acids and the other pumps bases)
Diuretics MOA - answer✔Blockade of sodium and chloride reabsorption; site of action - proximal tubule,
which produces greatest diuresis. Adverse effects: hypovolemia, acid-base imbalance, electrolyte
imbalances
Four major classifications of diuretics - answer✔Loops: furosemide; Thiazide: hydrochlorothiazide;
osmotic: mannitol; potassium-sparing: aldosterone antagonists (spironolactone) and non-aldosterone
antagonists (triamterene); carbonic anhydrase inhibitors
Furosemide (Lasix) - answer✔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 adverse effects - answer✔Hyponatremia, hypochloremia, and dehydration; hypotension;
hypokalemia; ototoxicity
Furosemide drug interactions - answer✔Digoxin, ototoxic drugs, potassium-sparing diuretics, lithium,
antihypertensive agents, NSAIDs
, ©THEBRIGHT EXAM SOLUTIONS
11/9/2024 2:18 PM
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 adverse effects - answer✔Hyponatremia, hypochloremia, and dehydration; hypokalemia;
hyperglycemia; hyperuricemia
HCTZ drug interactions - answer✔Digoxin; augments effects of hypertensive medications; can reduce
renal excretion of lithium (leading to accumulation of lithium); NSAIDs may blunt diuretic effect; can be
combined with ototoxic agents without increased risk of hearing loss
Potassium-sparing diuretics - answer✔Useful responses: modest increase in urine production and
substantial decrease in potassium excretion. Rarely used alone for therapy. Aldosterone antagonist:
spironolactone. Non-aldosterone antagonists: triamterene and amiloride
Spironolactone - answer✔MOA: blocks aldosterone in the distal nephron; causes retention of
potassium; increased excretion of sodium. Uses: HTN, edematous states, HF, primary
hyperaldosteronism, premenstrual syndrome, PCOS, acne in young women, hirsutism
Spironolactone adverse effects - answer✔Hyperkalemia, benign and malignant tumors, endocrine
effects. Drug interactions: thiazide and loop diuretics; agents that raise potassium levels
Triamterene - answer✔MOA: disrupts sodium-potassium exchange in the distal nephron; direct inhibitor
of the exchange mechanism; decreases sodium reuptake; inhibits ion transport. Uses: HTN, edema
Triamterene adverse effects - answer✔Hyperkalemia, leg cramps, N/V, dizziness, blood dycrasias
Amiloride - answer✔MOA: blocks sodium-potassium exchange in the distal nephron. Use: counteracts
potassium loss caused by more powerful diuretics. Adverse effects: hyperkalemia. Drug interactions:
ACE inhibitors; other drugs that cause hyperkalemia.
Mannitol - answer✔Osmotic diuretic. Promotes diuresis by creating osmotic force within lumen of the
nephron. Must be given IM/IV. Uses: prophylaxis of renal failure; reduction of intracranial and
intraocular pressure.
Mannitol adverse 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
