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Module 104: Theme 3 > Diuretic agents > Flashcards

Diuretic agents Flashcards

1
Q

Loop diuretics:

  • Mechanism of action
  • Administration
  • Examples [3]
A

Mechanism:

  • Inhibits NKCC2 co-transporter on the ASCENDING loop of Henle
  • Increases delivery of Na+ to distal tubule, promoting natriuresis.

Administration:

  • Oral
  • IV
  • IM

Examples:

  • Furosemide
  • Bumetanide
  • Torasemide
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2
Q

Indications for Loop diuretics- like furosemide

A
  • Acute pulmonary oedema
  • Chronic heart failure
  • Liver cirrhosis
  • Resistant hypertension
  • Nephrotic syndrome
  • Acute renal failure
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3
Q

Unwanted effects of loop diuretics

A

Dehydration

Hypokalemia
- potentiates the effects of cardiac glycosides.

Deafness- when used with aminoglycoside antibiotics

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4
Q

Osmotic diuretics:

  • Mechanism of action
  • Example
A

Mechanism:

  • Acts on the proximal tubule and the descending loop of Henle.
  • Inhibits the reabsorption of water and Na+

Example:
- Mannitol

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5
Q

Indications for osmotic diuretics [4]

A

Cerebral oedema

Reduces intracranial pressure in glaucoma

Elimination of toxins via osmotic diarrhea

Acute renal failure

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6
Q

Unwanted effects of osmotic diuretics

A

Increases plasma volume by exerting osmotic pressure

- Cannot be used for hypertension

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7
Q

Kaliuretics

A

Diuretics that promote K+ excretion.

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8
Q

Natriuretics

A

Diuretics that promote Na+ excretion.

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9
Q

Aquaretics

A

Diuretics that promote water excretion without Na+ excretion.

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10
Q

Carbonic anhydrase inhibitors:

  • Mechanism of action
  • Example
A

Mechanism:

  • Acts on proximal tubule
  • Blocks H2CO3 formation, prevents Na+ and HCO3- reabsorption.
  • Prevents Na+ being exchanged for H+, formed from carbonic acid.

Example:
Acetazolamide [Diamox]

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11
Q

Carbonic anhydrase inhibitor indications

A

Reducing intraoccular pressure in glaucoma

Decrease volume and pressure of CSF in epilepsy.

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12
Q

Unwanted effects of carbonic anhydrase inhibitors

A

Metabolic acidosis

Increased production of renal stone

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13
Q

Potassium sparing diuretics:

  • Mechanism of action
  • Examples [4]
A

Mechanism:

  • Acts on distal tubule
  • Competitively antagonises aldosterone.
  • This inhibits the increased production of Na+ channels, reducing Na+ reabsorption.
  • Affects protein synthesis—-> takes days to work.

Examples:

  • Spironolactone
  • Eplerenone
  • Triamterene
  • Amiloride
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14
Q

Indications of K+ sparing diuretics

A

Heart failure

Oedema

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15
Q

Unwanted effects of K+ sparing diuretics

A

Hyperkalemia- does not increase secretion of K+

Metabolic acidosis

GI upsets

Gynaecomastia
Menstrual
Testicular atrophy

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16
Q

Amiloride and triamterene

A

Potassium sparing diuretics

Physically blocks apical Na+ channels instead of antagonising aldosterone like other K+ sparing drugs.

17
Q

Combining diuretic agents

A

Used to:
Increases diuretic effects

Avoid hypokalemia

  • Loop/thiazide combined with K+ sparing
  • Loop/thiazide given with K+ solution.
  • Use diuretics containing K+
18
Q

Thiazide diuretics:

  • Mechanism of action
  • Examples [2]
A

Mechanism:

  • Acts on distal tubule
  • Inhibits Na+/Cl- co-transporter
  • Blocks Na+ absorption on apical membrane= natriuresis

Examples:

  • Bendroflumethiazide
  • Hydrochlorothiazide
19
Q

Indications for thiazide diuretics

A

Hypertension

Oedema

Mild heart failure

20
Q

Unwanted effects of thiazide diuretics [6]

A

Hypokalemia

Metabolic alkalosis:

  • More stress placed on Na+/H+ exchanger to absorb Na+
  • Promotes H+ loss

Increase in Uric acid= gout

Hyperglycaemia due to increased Ca2+ absorption

Hypercholesterolemia

Male impotence

21
Q

Thiazie-like diuretics

  • Mechanism
  • Examples [4]
A

Like thiazide diuretics but with a different molecular structure.
- Inhibits Na+/Cl- co-transporter

Examples:

  • Indapamide
  • Benzthiazide
  • Metolazone
  • Xipamide
22
Q

Xanthines

A

Chemical found in caffeine, theobromine, used as bronchodilator.

Acts as a weak diuretic- possible due to dilation of afferent arteriole.

23
Q

ADH antagonists

A

Potential diuretics
- Prevents ADH making collecting duct impermeable to water, increasing aquaresis

Examples: 
Lithium
Demeclocycline
Amphotericin B
Tolvaptan

These examples are either toxic or not that effective

24
Q

Effectiveness of diuretics

A

Loop diuretics are the most effective:

Loop> Thiazide > Potassium sparing

25
Q

Lasilactone

A

Furosemide + spironolactone

26
Q

Co-amilofruse

A

Furosemide + amiloride

27
Q

Co-flumactone

A

Hydroflumethiazide + spironolactone

28
Q

Co-amilozide

A

Hydrocholrothiazide + amiloride

Module 104: Theme 3 (13 decks)

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