Diuretics

Question 1

Why are the osmotic diuretics contraindicated in CHF and pulmonary edema?

Answer 1

Osmotic diuretics draw water from cells ▶️ ⬆️ filling pressures of the heart

Question 2

What type of adverse event can you precipitate if combine amino glycosides with loop diuretics?

Answer 2

Ototoxicity

Question 3

Unique loop diuretic that don’t have cross allergic reaction with sulfonamides

Answer 3

Ethacrynic acid

*Sulfa containing drugs: possible cross allergic
Celecoxib, carbonic anhydrase inhibitor, loop diuretics, thiazides, sulfa antibiotics

Question 4

Different between thiazide and loop diuretics

Answer 4

• Loop ▶️ ⬆️ calcium excretion

- Thiazides ▶️ ⬇️ calcium excretion (can use in osteoporosis)

Question 5

Why osteoporosis patient should not use loop diuretics?

Answer 5

Loose too much calcium (reabsorption is ⬇️⬇️)

*may benefit on hypercalcemic state
“loops loose calcium”

Question 6

Why HCTZ can lead hyperglycemia?

Answer 6

Hypokalemia caused by HCTZ ▶️ ⬇️ insulin

*avoid in DM

Question 7

Treatment for lithium-induced nephrogenic diabetes insipidus.

Answer 7

Amiloride

Question 8

What can result of combine K+ sparing diuretics with ACEIS or ARBs?

Answer 8

Hyperkalemia

Question 9

Unique diuretic that cause hypokalemia and acidosis. Why?

Answer 9

Carbonic anhydrase inhibitor

HCO3 can be reabsorbed (loose), ⬇️ Na+/H+ antiport (H+ cannot get out to urine)

Question 10

Which diuretics can cause vasodilation?

Answer 10

Loop and thiazide