Lehne’s Pharmacotherapeutics
EXAMINATION SET 2026 SOLVED
QUESTIONS GRADED A+
● The kidney produces effects on the ECF through three processes:.
Answer: 1. Filtration - occurring at the glomerulus (for small molecules
like electrolytes and glucose; large molecules like lipids and proteins
remain in the blood)
2. Reabsorption - takes place by way of active transport across water
soluble osmotic gradient; determines the contents of urine; diuretics
work to interfere with this process by blockading mainly sodium and
chloride reabsorption which prevents the passive reabsorption of water
causing water and these electrolytes to stay within the nephron and
become excreted together
3. Active Secretion - located at pumps in the proximal convoluted tubule
● How does aldosterone act on the nephrons?. Answer: As a principal
mineralocoticoid of the adrenal cortex, it stimulates reabsorption of
sodium from the distal nephron. Simultaneously, it causes potassium to
be secreted.
● Adverse effects of diuretics (as an overall drug class). Answer:
Hypovolemia
,Acid-Base Imbalances
Altered Electrolyte Levels
Combat these by using short-acting diuretics and by timing dosing so
that the kidney has periods of operation unaffected by drug-induced
diuresis
● What is the function of carbonic anhydrase inhibitors?. Answer: They
are classed as diuretics but are employed primarily to lower intraocular
pressure (IOP) - they do not increase urine production.
● Lasix (furosemide). Answer: Classification: Loop Diuretic
Therapeutic Effects: Lowering of blood pressure by creating large
volume loss and substantial relaxation of venous smooth muscle
contractions which reduces venous return to the heart; Acts in loop of
Henle to block sodium and chloride reabsorption (which is usually a
20% reabsorption rate) so creates major DIURESIS
Adverse Reactions & side effects: Dehydration, hypochloremia,
hypokalemia, hypomagnesaemia, hyponatremia, hypovolemia,
metabolic alkalosis, oliguria, hyperglycemia, reduction of HDL
cholesterol, increase in LDL and triglycerides
, Nursing Implications & teaching:
-DIURESIS BEGINS WITHIN 30 MINUTES - drug to be taken early in
the day! Usually administered for situations that require massive
mobilization of fluid (pulmonary edema associated with HF, edema of
hepatic cardiac or renal origin unresponsive to other diuretics and
hypertension that is unaffected by other diuretics).
-Is more useful in patients with severe renal impairment because when
renal blood flow and GFR are low, it can still promote diuresis (unlike
thiazide diuretics)
-Monitor for unusual thirst, dry mouth, lethargy, hypotension (weakness,
dizziness, lightheadedness, fainting; combated by rising slowly), oliguria
and hearing impairment (ototoxicity-is transient unless formed by
ethacrynic acid which causes irreversible damage; risk is increased if
patient is on other ototoxic drugs such as aminoglycoside antibiotics
such as gentamicin)
-Monitor K+(fatal if less than 3.5 due to dysthymias - combat loss with
potassium sparing diuretics, consuming potassium rich foods such as
Spinach, potato and bananas or taking potassium supplements) Ca++,
Mg and daily weight!
-Can increase BUN, glucose and creatinine, TAKE WITH FOOD
- Use caution in pregnant or lactating women (may cause fetal death and
decrease in breast mil
● Hydrochlorothiazide (HCTZ) (Microzide). Answer: Classification:
Loop Diuretic
EXAMINATION SET 2026 SOLVED
QUESTIONS GRADED A+
● The kidney produces effects on the ECF through three processes:.
Answer: 1. Filtration - occurring at the glomerulus (for small molecules
like electrolytes and glucose; large molecules like lipids and proteins
remain in the blood)
2. Reabsorption - takes place by way of active transport across water
soluble osmotic gradient; determines the contents of urine; diuretics
work to interfere with this process by blockading mainly sodium and
chloride reabsorption which prevents the passive reabsorption of water
causing water and these electrolytes to stay within the nephron and
become excreted together
3. Active Secretion - located at pumps in the proximal convoluted tubule
● How does aldosterone act on the nephrons?. Answer: As a principal
mineralocoticoid of the adrenal cortex, it stimulates reabsorption of
sodium from the distal nephron. Simultaneously, it causes potassium to
be secreted.
● Adverse effects of diuretics (as an overall drug class). Answer:
Hypovolemia
,Acid-Base Imbalances
Altered Electrolyte Levels
Combat these by using short-acting diuretics and by timing dosing so
that the kidney has periods of operation unaffected by drug-induced
diuresis
● What is the function of carbonic anhydrase inhibitors?. Answer: They
are classed as diuretics but are employed primarily to lower intraocular
pressure (IOP) - they do not increase urine production.
● Lasix (furosemide). Answer: Classification: Loop Diuretic
Therapeutic Effects: Lowering of blood pressure by creating large
volume loss and substantial relaxation of venous smooth muscle
contractions which reduces venous return to the heart; Acts in loop of
Henle to block sodium and chloride reabsorption (which is usually a
20% reabsorption rate) so creates major DIURESIS
Adverse Reactions & side effects: Dehydration, hypochloremia,
hypokalemia, hypomagnesaemia, hyponatremia, hypovolemia,
metabolic alkalosis, oliguria, hyperglycemia, reduction of HDL
cholesterol, increase in LDL and triglycerides
, Nursing Implications & teaching:
-DIURESIS BEGINS WITHIN 30 MINUTES - drug to be taken early in
the day! Usually administered for situations that require massive
mobilization of fluid (pulmonary edema associated with HF, edema of
hepatic cardiac or renal origin unresponsive to other diuretics and
hypertension that is unaffected by other diuretics).
-Is more useful in patients with severe renal impairment because when
renal blood flow and GFR are low, it can still promote diuresis (unlike
thiazide diuretics)
-Monitor for unusual thirst, dry mouth, lethargy, hypotension (weakness,
dizziness, lightheadedness, fainting; combated by rising slowly), oliguria
and hearing impairment (ototoxicity-is transient unless formed by
ethacrynic acid which causes irreversible damage; risk is increased if
patient is on other ototoxic drugs such as aminoglycoside antibiotics
such as gentamicin)
-Monitor K+(fatal if less than 3.5 due to dysthymias - combat loss with
potassium sparing diuretics, consuming potassium rich foods such as
Spinach, potato and bananas or taking potassium supplements) Ca++,
Mg and daily weight!
-Can increase BUN, glucose and creatinine, TAKE WITH FOOD
- Use caution in pregnant or lactating women (may cause fetal death and
decrease in breast mil
● Hydrochlorothiazide (HCTZ) (Microzide). Answer: Classification:
Loop Diuretic
