Drugs Acting On Kidney Question And Answers

Drugs Acting On Kidney Important Notes

1. Classification of diuretics

• High ceiling diuretics
  • Furosemide
  • Bumetanide
  • Torsemide
• Moderate efficacy diuretics
  • Thiazides – chlorothiazides, hydrochlorothiazides
  • Thiazide related agents – chlorthalidone,, clopamide
• Low efficacy diuretics
  • Potassium sparing diuretics – triamterene, amiloride, spironolactone
  • Carbonic anhydrase inhibitor – acetazolamide .
  • Osmotic diuretics – Mannitol, urea
  • Methylxanthines – theophylline
• Newer agents
  • Vasopressin antagonists
  • Conivaptan

Diuretics Drugs

2. Complications of high ceiling diuretics and thiazides

• Hypokalaemia
• Dilutional hyponatremia
• GIT and CNS disturbances
• Hearing loss
• Magnesium depletion
• Hyperuricaemia
• Hyperglycaemia
• Hyperlipidaemia
• Acute saline depletion
• Fall in BP

3. Drugs contraindicated in renal failure are

• Cephalothin
• Cephaloridine
• Nalidixic acid
• Nitrofurantoin
• Talampicillin
• Tetracyclines

Diuretics Drugs

4. Drugs that require dose reduction in renal failure are:

Drugs Acting On Kidney Short Essays

Question 1. Classify diuretics. Write the mechanism of action of thiazides
Answer:

Diuretics:

• Drugs that increase urine and solute excretion causing loss of sodium and water from the body are called diuretics.

Diuretics Classification:

1. High efficacy or loop diuretics

• Furosemide, Bumetanide, Torasemide

2. Medium efficacy diuretics

• Benzothiadiazine or thiazides
  • Hydrochlorothiazide, Benzthiazide
• Thiazides like drugs
  • Chlorthalidone, Metolazone

Diuretics Drugs

3. Low efficacy or weak diuretics

• Carbonic anhydrase inhibitors
  • Acetazolamide
• Potassium sparing diuretic
  • Aldosterone antagonist- spironolactone
  • Inhibitors of renal epithelial sodium channel- Triamterene, amiloride
• Osmotic diuretics
  • Mannitol, isosorbide, Glycerol

Mechanism of Action of Thiazides:

Question 2. Compare acetazolamide and frusemide.
Answer:

Question 3. Compare frusemide and spironolactone
Answer:

Question 4. Compare chlorothiazide and spironolactone
Answer:

Diuretics Drugs

Question 5. Compare Hydrochlorothiazide and frusemide
Answer:

Question 6. Chlorothiazide
Answer:

• Chlorothiazide is a medium efficacy thiazide diuretics

Chlorothiazide Uses:

• Hypertension
• Congestive cardiac failure
• Hepatic or renal edema –
• Hypercalciuria with renal stones
• Diabetes insipidus

Chlorothiazide Adverse Effects:

• Hypokalaemia
• Carbohydrate intolerance
• Fatigue, loss of energy
• Impotence
• Hyperlipidaemia, hyperuricemia
• Decreased libido

Read And Learn More: Pharmacology Question and Answers

Question 7. Mention two therapeutic uses and two adverse effects of frusemide.
Answer:

Frusemide:

• It is high efficacy diuretics

Frusemide Uses:

• Edema
• Hypertension
• Forced diuresis
• Hypercalcaemia
• Renal stones
• During blood transfusions

Frusemide Adverse Effects:

• Acute salt depletion
• Hepatic coma
• Photosensitivity
• Headache
• Giddiness
• Nausea, vomiting
• Paresthesia, impotence

Question 8. Complications of diuretics.
Answer:

1. Hypokalaemia

• Occurs with high ceiling diuretics and thiazides
• Characterized by weakness, fatigue, muscle cramps, cardiac arrhythmias
• Treatment:
  • High dietary potassium intake
  • Supplements of KC1
  • Concurrent use of potassium-sparing diuretics

2. Acute saline depletion

• Causes dehydration and a fall in blood pressure

3. Hyponatremia – more with high ceiling diuretics

4. GIT disturbances – nausea, vomiting, diarrhea

5. CNS disturbances – headache, giddiness, weakness, paraesthesia

6. Hearing loss – with high-ceiling diuretics

7. Hypersensitivity – skin rashes, feverhyperuricaemia – with long-term use of thiazides

8. Hyperglycaemia, hyperlipidemia – when diuretics are used as antihypertensives

9. Magnesium depletion – due to prolonged use

10. Hyperkalaemia – with potassium-sparing diuretics

Drugs Acting On Kidney Short Question And Answers

Question 1. Potassium-sparing diuretics
Answer:

• Potassium-sparing diuretics are:
  • Spironolactone
  • Triamterene
  • Amiloride

Potassium-sparing diuretics Mechanism:

• Act as aldosterone antagonists
• Directly inhibit ion channels

Potassium-sparing diuretics Site of Action:

• Act as aldosterone antagonists
• Directly inhibits ion channels

Potassium-sparing diuretics Uses:

• Used along with thiazides and loop diuretics to prevent potassium loss
• Edema
• Hypertension
• Aldosteronism

Question 4. Mannitol
Answer:

• Mannitol is an osmotic diuretics
• It helps to retain water in the proximal convoluted tubule and the descending limb of the Henle’s loop by osmosis
• This causes water diuresis and loss of sodium
• They are ineffective when given orally
• So it is given IV

Mannitol Uses:

• To maintain urine volume and prevent oliguria during hemolysis and shock.
• Used in the reduction of intracranial and intraocular pressure

Mannitol Adverse Effects:

• Dehydration
• ECF volume expansion
• Headache
• Hyperallergic reactions

Question 5. Spironolactone
Answer:

• Spironolactone is a potassium-sparing diuretic
• It is low efficacy diuretics
• It is an aldosterone antagonists

Spironolactone Uses:

• In the treatment of Hypercalcaemia and renal stones
• Along with other diuretics in the treatment of hypertension, to reduce hypokalaemia
• In the treatment of aldosteronism

Spironolactone Adverse Effects:

• Drowsiness
• Hyperkalemia in patients with renal insufficiency
• Gynaecomastia
• Skin rashes

Question 6. Loop diuretics
(or)
High ceiling diuretics
Answer:

• Loop diuretics are high efficacy diuretics
• They act by inhibiting sodium chloride reabsorption in the ascending limb of Henle’s loop
• They include
  • Frusemide
  • Bumetanide
  • Piretanide

Loop diuretics Uses:

• Edema- cardiac, cerebral, hepatic, renal, pulmonary
• Hypertension
• Hypercalcaemia, Renal stones
• Hyperkalemia
• Barbiturate poisoning to induce forced diuresis

Question 7. Osmotic diuretics
Answer:

• Osmotic diuretics include inert drugs like
  • Mannitol
  • Urea
  • Glycerol
• It helps to retain water in the proximal convoluted tubule and the descending limb of the Henle’s loop by osmosis
• This causes water diuresis and loss of sodium
• They are ineffective when given orally
• So it is given IV

Osmotic diuretics Uses:

• To maintain urine volume and prevent oliguria during hemolysis and shock.
• Used in the reduction of intracranial and intraocular pressure

Osmotic diuretics Adverse Effects:

• Dehydration
• ECF volume expansion
• Headache
• Hyperallergic reactions

Question 8. Triamterene and frusemide
Answer:

Question 9. Rationale of combining thiazides with spironolactone
(or)
The rationale for combining spironolactone with frusemide
Answer:

• Frusemide and Thiazides cause excess excretion of potassium from the body
• The sodium present in the distal convoluted tubule may also be exchanged for potassium ions which may be excreted in the urine
• This may lead to hypokalaemia
• Spironolactone reduces potassium loss by inhibiting the action of aldosterone which is responsible for potassium secretion
• So spironolactone is combined with Frusemide or Thiazide

Question 10. Enlist three diuretic drugs and one different use for each.
Answer:

Question 11. Name two loop diuretics. Mention two uses of them.
Answer:

Loop Diuretics:

• Frusemide
• Bumetanide
• Torasemide

Loop Diuretics Uses:

• Edema
• Acute Pulmonary Edema
• Hypertension