Ch. 25: Diuretics and Therapeutic Drug Monitoring (Vickroy) Flashcards Preview

Pharmacology > Ch. 25: Diuretics and Therapeutic Drug Monitoring (Vickroy) > Flashcards

Flashcards in Ch. 25: Diuretics and Therapeutic Drug Monitoring (Vickroy) Deck (21):
1

order diuretics in order of decreasing diuretic effect

mannitol < furosemide < chlorothiazide < spironolactone/triamterene

2

where are sensing mechs. for electrolyte/fluid balance?

plasma/vasculature. Not good at detecting edema in Extracellular space

3

therapeutic uses of diuretics

-severe edema (from liver/kidney failure, brain injury, hyperparathyroidism, pulmonary edema, CHF, DCM, etc.)
-elim. of toxic substances

4

edema

abnormal accum. of fluid in the interstitium

5

vascular changes that lead to edema form.

-inc. hydrostatic P
-dec. oncotic pressure
-inc. vascular permeability
-lymphatic blockage

6

composition of urine is determined by what factors?**

GFR, tubular secretion, tubular reabsorption of Na (<-- diuretics act on this)

7

where do osmotic diuretics act?

anywhere along the tubule

8

inhibition of acid secretion in proximal convoluted tubule by a diuretic will:

-inc. systemic actions of some acidic drugs (i.e. antibiotics)
-dec. diuresis by thiazides and loop diuretics

9

diuretic

agent that increases urine production via a DIRECT ACTION on the renal epithelium (except osmotic agents)

10

drugs that produce diuresis by indirect/non-tubular actions

xylazine (dec. ADH release, hyperglycemia)
digoxin (inc. CO --> renal perfusion)

11

common feature of almost all diuretic agents

increased Na excretion

12

therapeutic uses of mannitol**

-acute renal failure*
-cerebral edema WITHOUT intracranial hemorrhage
-elevated intraocular P
-promote renal excretion of drugs/toxins

13

contraindications of mannitol**

-heart failure*
-pulmonary edema or congestion*
-intracranial hemorrhage
-severe dehydration
-renal dz

14

all thiazides are acidic/basic drugs with structural resemblence to ____**

acidic; sulfonamides

15

what is required for diuretic action of chlorothiazide?**

acid transporter

16

therapeutic indications of chlorothiazide

-edema
-diabetes insipidus
-Ca oxalate urolithiasis

17

therapeutic indications of furosemide

-edema
-hypercalcemia (increases Ca loss)
-epistasis due to exercise-induced pulmonary hemmorhage

18

serum electrolyte changes with extended use of furosemide

-hypokalemia
-metabolic alkalosis
-hypocalcemia
-hyperuricemia

19

drug interactions of furosemide

-aminoglycosides
-cephalosporins
-corticosteroids
-NSAIDs
-plasma protein binding

20

electrolyte changes with extended use of K-sparing diuretics

-hyperkalemia
-azotemia

21

why is triamterene commonly used in combo with thiazide or loop diuretics?

diminishes K loss