Medications Affecting Urinary Output, Antianginal and Lipid-Lowering Agents

Vocabulary practice cards focusing on prototypes, mechanisms of action, and critical side effects of diuretics, antianginals, and lipid-lowering medications.

Furosemide (Lasix)

A high-ceiling loop diuretic prototype that blocks the $Na$-$K$-$2Cl$ transporter in the thick ascending loop of Henle to remove sodium, chloride, and water.

Ototoxicity

A serious adverse reaction of Furosemide that can cause tinnitus or hearing loss, particularly with rapid IV administration or use of other ototoxic drugs.

Spironolactone (Aldactone)

A potassium-sparing diuretic and aldosterone antagonist prototype that excretes sodium and water while retaining potassium; also reduces cardiac fibrosis and remodeling.

Gynecomastia

An endocrine side effect of Spironolactone (Aldactone) that occurs because the drug affects steroid receptors, which can also lead to breast tenderness or menstrual changes.

Mannitol (Osmitrol)

An osmotic diuretic prototype that raises plasma and renal-tubule osmotic pressure to pull water from swollen tissues, such as the brain or eye, into the bloodstream.

Rebound intracranial pressure

A serious adverse reaction of Mannitol (Osmitrol) that can occur if the medication accumulates or if therapy is prolonged.

Nitroglycerin (Nitrostat / Nitro-Dur)

An organic nitrate and vasodilator prototype that is converted to nitric oxide, increasing cyclic GMP to dilate veins more than arteries and reduce preload.

PDE-5 inhibitors

A class of drugs that, when combined with organic nitrates like Nitroglycerin, can cause life-threatening or fatal hypotension.

Ranolazine (Ranexa)

A late sodium-current inhibitor used for chronic angina that reduces intracellular $Ca^{2+}$ overload, allowing the heart to relax better during diastole without greatly lowering heart rate or BP.

QT prolongation

A dose-related serious adverse reaction of Ranolazine (Ranexa) that can lead to dangerous dysrhythmias.

Atorvastatin (Lipitor)

An HMG-CoA reductase inhibitor (statin) prototype that inhibits a key liver enzyme in cholesterol production, leading to increased liver LDL receptors and lower blood LDL.

Rhabdomyolysis

A serious adverse reaction of Atorvastatin (Lipitor) involving muscle injury that can cause severe weakness, kidney injury, and dark urine.

Ezetimibe (Zetia)

A cholesterol absorption inhibitor prototype that blocks the NPC1L1 transporter at the intestinal brush border to decrease dietary and biliary cholesterol absorption.

Colesevelam (Welchol)

A bile-acid sequestrant prototype that remains in the gut to bind bile acids, preventing their reabsorption and forcing the liver to use cholesterol to make replacements.

Alirocumab (Praluent)

A PCSK9 inhibitor monoclonal antibody prototype administered subcutaneously that prevents the destruction of liver LDL receptors, thereby greatly lowering LDL levels.

NPC1L1 transporter

The specific transporter at the intestinal brush border blocked by Ezetimibe (Zetia) to inhibit cholesterol absorption.

Nitrate-free interval

A daily period recommended for patients using long-acting forms of Nitroglycerin to reduce the development of drug tolerance.

Hyperkalemia

A major risk associated with Spironolactone (Aldactone) where potassium levels become dangerously high, potentially causing paralysis or fatal dysrhythmias.