C- Diuretics & RAAS Antagonists Flashcards Preview

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Flashcards in C- Diuretics & RAAS Antagonists Deck (34)
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1
Q

CO=

A

HR*SV

2
Q

Increase Cardiac Output by increasing

A

Intropy
Heart Rate
Preload

3
Q

Decrease CO by

A

Inc. Afterload

4
Q

Specific Goals of Heart Failure Management with Pharmacotherapy

A

Reduction of congestion
Modulate neurohormonal activation
Improve flow

5
Q

Used first as needed to reduce congestion
Reverse Na+ and fluid retention
Relieve volume overload: dyspnea peripheral edema
Lowers preload (LVEDP)

A

Diuretics

6
Q

resulting in long-term stabilization, positive remodeling, and increased survival with RAAS antagonists and β-blockers

A

Modulate neurohormonal activation

7
Q

Loop diuretics preferred because of ______- can augment with a thiazide diuretic

A

efficacy

8
Q

may be difficult to accomplish pharmacotherapeutically with vasodilators and requires mechanical devices or transplantation

A

improve flow

9
Q

ALDO–> Na+ sparing is the _______ but can cause K+ wasting

A

Major action

10
Q

ALDO antagonists are ____ sparing

A

K+ sparing

11
Q

fluid optimization with diuretics is a major part of heart failure therapy

A

Reduction of congestion

12
Q

ALDO–> Na+ sparing is the major action but can cause ______

A

K+ wasting

13
Q

ACE-ARB are ____ sparing

A

K+ sparing

14
Q

Furosemide ______diructic

A

most common

15
Q

Loop and thiazide are both ____ wasting

A

K+

16
Q
#11: Hydrochlorothiazide 
#14: Furosemide (Lasix®) 
#42: HCTZ-Triamterene (Dyazide) 
#70: Spironolactone (Aldactone®)
A

Important diuretics

17
Q

most common diuretic

A

Furosemide

18
Q

Interactions with membrane transport proteins
• Interactions with enzymes (acetazolamide) or hormone receptors (spironolactone)
• Osmotic effects preventing water reabsorption (mannitol)

A

Mechanisms of diuretics

19
Q

Important diructics from top 200 list

A
#11: Hydrochlorothiazide 
#14: Furosemide (Lasix®) 
#42: HCTZ-Triamterene (Dyazide) 
#70: Spironolactone (Aldactone®)
20
Q

Most diuretics exert effects at __________ surface of renal tubule cells

A

luminal (urine)

21
Q

Inhibit NaCl transport (Na+-K+-2Cl–transporter) in TAL - greatest efficacy due to large capacity of this segmen

Associated with increase in Mg++, Ca++ excretion (diminish lumen-positive potential)

A

Loop Diuretics

22
Q

_________ diuretics act via inhibition of Na+-K+-ATPase

A

No, None, Nada

23
Q

Diuretic agents decrease _________ at various sites in the nephron

A

Na+ reabsorption

24
Q

In loop diuretics:
Handled by glomerular filtration and renal secretion (same organic acid transporter as uric acid)
Is the mechanism for?

A

Mechanism for hyperuricemia

25
Q

Loop Diuretics

Use in Heart Failure

A

Used in HF patients with volume overload
Efficacy is enhanced with salt restriction
Furosemide most commonly used

26
Q

Loop diuretics most _________ in HF

A

efficacious

27
Q

Loop Diuretics

Adverse Reactions

A

Hypokalemic metabolic alkalosis

Hyperuricemia

28
Q

Inhibit the Na+/Cl- cotransporter –> increased urinary excretion of NaCl
Modest diuretic effect since only 5-10% of filtered Na+ is reabsorbed here

A

Thiazide Diuretics

29
Q

Thiazides ________ of Ca++ ( NOTE: loop diuretics decrease serum Ca++ levels)

A

increase reabsorption

30
Q

Competitive antagonist at aldosterone receptor

A

Spironolactone

31
Q

Vasodilation Salt / Water Excretion

A

ACE INHIBITORS / ANGIOTENSIN RECEPTOR BLOCKER

Adrenergic and RAAS blockers- REDUCE MORBIDITY AND IMPROVE SURVIVAL

32
Q

Decreased Contractility

May worsen symptoms

A

BETA BLOCKERS

Adrenergic and RAAS blockers- REDUCE MORBIDITY AND IMPROVE SURVIVAL

33
Q

Thiazides increase reabsorption of Ca++ ( NOTE: loop diuretics _________ Ca++ levels)

A

decrease serum

34
Q

Salt / Water Excretion Potassium retention

A

ALDOSTERONE RECEPTOR BLOCKADE

Adrenergic and RAAS blockers- REDUCE MORBIDITY AND IMPROVE SURVIVAL