55. Loop diuretics Flashcards Preview

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Flashcards in 55. Loop diuretics Deck (14):
1

Proximal renal tubular acidosis, paresthesias,
NH3 toxicity, sulfa allergy.

Furosemide, bumetanide, torsemide
Ethacrynic acid

2

Furosemide, bumetanide, torsemide
(MECHANISM

Sulfonamide loop diuretics. Inhibit cotransport
system (Na+/K+/2Cl−) of thick ascending limb
of loop of Henle. Abolish hypertonicity of
medulla, preventing concentration of urine.
Stimulate PGE release (vasodilatory effect
on afferent arteriole); inhibited by NSAIDs.
Increased Ca2+ excretion. Loops Lose Ca2+.

3

Furosemide, bumetanid
e, torsemide
(CLINICAL USE)

Edematous states (HF, cirrhosis, nephrotic
syndrome, pulmonary edema), hypertension,
hypercalcemia.

4

Furosemide, bumetanide, torsemide
(ADVERSE EFFECTS)

Ototoxicity, Hypokalemia, Dehydration,
Allergy (sulfa)/metabolic Alkalosis, Nephritis
(interstitial), Gout.
Ototoxicity, Hypokalemia, Dehydration,
Allergy (sulfa)/metabolic Alkalosis, Nephritis
(interstitial), Gout.

5

Ethacrynic acid
MECHANISM

Nonsulfonamide inhibitor of cotransport system
(Na+/K+/2Cl−) of thick ascending limb of loop
of Henle.

6

Ethacrynic acid
CLINICAL USE

Diuresis in patients allergic to sulfa drugs

7

Ethacrynic acid
(ADVERSE EFFECTS)

Similar to furosemide, but more ototoxic.

loop hurt your ears

8

• What are three (general) clinical uses for loop diuretics?

To treat edematous states (congestive heart failure, cirrhosis, nephrotic syndrome, pulmonary edema), hypertension, and hypercalcemia

9

• What is the mechanism of action of loop diuretics?

They block Na+/K+/Cl- thick ascending limb cotransporters, abolish medullary hypertonicity, and prevent urine concentration

10

• What is the effect of the loop diuretic furosemide on calcium handling in the kidney nephron?

Furosemide increases calcium excretion (Loops Lose calcium)

11

• Name at least four toxicities associated with using loop diuretics.

Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis (interstitial), Gout (OH DANG!)

12

• Ethacrynic acid (a phenoxyacetic acid derivative) is an alternative to ____ for patients who suffer from ____. Name one toxicity.

Loop diuretics (furosemide, bumetanide, torsemide); sulfa allergies; hyperuricemia (never use ethacrynic acid to treat gout)

13

• A patient taking torsemide is noted to have dilated renal afferent arterioles. This effect is blocked by NSAIDs. What is happening?

Torsemide, a loop diuretic, dilates the afferent arterioles by stimulating prostaglandin E (PGE) release, an effect inhibited by NSAIDs

14

• A patient with a sulfa allergy needs urgent loop diuretic diuresis due to heart failure. What medication can you offer him?

Ethacrynic acid (it is a phenoxyacetic acid derivative, not a sulfonamide)

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