©Themoon EXAM SOLUTIONS
12/11/2024 5:18PM
Pharmacology 5334 Module 5 Test Questions
with Verified Answers
Cardiac output - Answers✓✓Average adult: 5 L/minute; heart rate X stroke volume; HR
controlled by the ANS; SV: myocardial contractility, cardiac afterload, cardiac preload
Preload - Answers✓✓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 - Answers✓✓Arterial pressure that the left ventricle must overcome to eject blood; if it
increases, stroke volume decreases, and vice versa.
Basic functions of diuretics - Answers✓✓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 - Answers✓✓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 - Answers✓✓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 - Answers✓✓Loops: furosemide; Thiazide:
hydrochlorothiazide; osmotic: mannitol; potassium-sparing: aldosterone antagonists
(spironolactone) and non-aldosterone antagonists (triamterene); carbonic anhydrase inhibitors
, ©Themoon EXAM SOLUTIONS
12/11/2024 5:18PM
Furosemide (Lasix) - Answers✓✓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 - Answers✓✓Hyponatremia, hypochloremia, and dehydration;
hypotension; hypokalemia; ototoxicity
Furosemide drug interactions - Answers✓✓Digoxin, ototoxic drugs, potassium-sparing diuretics,
lithium, antihypertensive agents, NSAIDs
Other loop diuretics - Answers✓✓Ethacrynic acid, Bumetanide, Torsemide. All can cause:
ototoxicity, hypovolemia, hypotension, hypokalemia, hyperuricemia, hyperglycemia, and
disruption of lipid metabolism
Thiazide Diuretics (benzothiazides) - Answers✓✓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 - Answers✓✓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 - Answers✓✓Hyponatremia, hypochloremia, and dehydration;
hypokalemia; hyperglycemia; hyperuricemia
HCTZ drug interactions - Answers✓✓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
, ©Themoon EXAM SOLUTIONS
12/11/2024 5:18PM
Potassium-sparing diuretics - Answers✓✓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 - Answers✓✓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 - Answers✓✓Hyperkalemia, benign and malignant tumors,
endocrine effects. Drug interactions: thiazide and loop diuretics; agents that raise potassium
levels
Triamterene - Answers✓✓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 - Answers✓✓Hyperkalemia, leg cramps, N/V, dizziness, blood
dycrasias
Amiloride - Answers✓✓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 - Answers✓✓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 - Answers✓✓Edema, headache, nausea, vomiting, fluid and electrolyte
imbalance
Actions of aldosterone - Answers✓✓Regulation of blood volume and blood pressure; helps with
pathologic CV effects
12/11/2024 5:18PM
Pharmacology 5334 Module 5 Test Questions
with Verified Answers
Cardiac output - Answers✓✓Average adult: 5 L/minute; heart rate X stroke volume; HR
controlled by the ANS; SV: myocardial contractility, cardiac afterload, cardiac preload
Preload - Answers✓✓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 - Answers✓✓Arterial pressure that the left ventricle must overcome to eject blood; if it
increases, stroke volume decreases, and vice versa.
Basic functions of diuretics - Answers✓✓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 - Answers✓✓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 - Answers✓✓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 - Answers✓✓Loops: furosemide; Thiazide:
hydrochlorothiazide; osmotic: mannitol; potassium-sparing: aldosterone antagonists
(spironolactone) and non-aldosterone antagonists (triamterene); carbonic anhydrase inhibitors
, ©Themoon EXAM SOLUTIONS
12/11/2024 5:18PM
Furosemide (Lasix) - Answers✓✓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 - Answers✓✓Hyponatremia, hypochloremia, and dehydration;
hypotension; hypokalemia; ototoxicity
Furosemide drug interactions - Answers✓✓Digoxin, ototoxic drugs, potassium-sparing diuretics,
lithium, antihypertensive agents, NSAIDs
Other loop diuretics - Answers✓✓Ethacrynic acid, Bumetanide, Torsemide. All can cause:
ototoxicity, hypovolemia, hypotension, hypokalemia, hyperuricemia, hyperglycemia, and
disruption of lipid metabolism
Thiazide Diuretics (benzothiazides) - Answers✓✓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 - Answers✓✓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 - Answers✓✓Hyponatremia, hypochloremia, and dehydration;
hypokalemia; hyperglycemia; hyperuricemia
HCTZ drug interactions - Answers✓✓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
, ©Themoon EXAM SOLUTIONS
12/11/2024 5:18PM
Potassium-sparing diuretics - Answers✓✓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 - Answers✓✓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 - Answers✓✓Hyperkalemia, benign and malignant tumors,
endocrine effects. Drug interactions: thiazide and loop diuretics; agents that raise potassium
levels
Triamterene - Answers✓✓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 - Answers✓✓Hyperkalemia, leg cramps, N/V, dizziness, blood
dycrasias
Amiloride - Answers✓✓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 - Answers✓✓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 - Answers✓✓Edema, headache, nausea, vomiting, fluid and electrolyte
imbalance
Actions of aldosterone - Answers✓✓Regulation of blood volume and blood pressure; helps with
pathologic CV effects
