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Flashcards in Diuretic Drugs Deck (15)
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1

Effects of Hyperkalemia (4) and Hypokalemia (4)

Hyper:
Tall T waves
Wide QRS
Flat P waves
Bradycardia

Hypo:
Flat T waves
ST depression
Tall U waves
Atrial arrhythmia

2

Loop Diuretics
MOA and Adverse Effects (5)

Block NaK2Cl cotransporter in thick ascending limb

Largest Na+ loss (also K+/Ca2+/Mg2+/Cl- lost)
Metabolic Alkalosis
Ototoxic
Sulfa Allergies
Hyperglycemia/Hyperuricemia

3

Loop Diuretics
Examples with Uses (4)

Furosemide: Pulmonary edema and low GFR pts.

Torsemide: Heart failure

Bumetanide: predictable absorption

Ethacrynic acid: non-sulfa (use in case of allergy)

4

Thiazide Diuretics
MOA (2) and Adverse Effects (4)

Blocks NaCl cotransporter in DCT
Spares Ca2+

Largest Mg2+ loss
Metabolic alkalosis
Sulfa allergies
Hypercalcemia/Hyperglycemia/Hyperuricemia

5

Hydrochlorothiazide
Uses (2), Not Useful For

Calcium nephrolithiasis
Nephrogenic Diabetes Insipidus

Not effective in pts with low GFR

6

Other Thiazides (3)
Which is best for HTN?

Chlorthalidone (best for HTN)

Chlorothiazide
Metolazone

7

Potassium Sparing Diuretics
MOA (2) Examples for Each MOA (2)

ENaC blocking in collecting duct
(Amiloride and Triamterene)

Competitive Aldosterone antagonist in collecting duct
(Spironolactone and Eplerone)

8

Amiloride/Triamterene
Use and Adverse Effects (6)

Blocking ENaC can counteract K+ loss from other diuretics

Hyperkalemia/Hyperchloremia
Metabolic Acidosis
Hyponatremia/volemia
Dizziness
Fatigue
N/V/D

9

Spironolactone/Eplerone
Uses (3) and Adverse (6)

Potassium loss
Primary Hyperaldosteronism
Post-MI Fibrosis

Hyperkalemia
Hyponatremia
Amenorrhea
Hirsutism
Impotence
Gynecomastia
(last 4 from partial androgen agonism)

10

Conivaptan
Drug Description, Use, Adverse (4)

Nonpeptide arginine antagonist


Treats euvolemic/hypovolemic hyponatremia

Seizure
Osmotic demyelination
Coma
Death

11

Tolvaptan
Drug Description, Uses (2) and Adverse Effect

selective oral V2 antagonist

Hyponatremia
Adult Polycystic Kidney Disease

Hepatotoxicity (use <30 days)

12

Aquaretics
Examples (2) and General MOA (2)

Conivaptan
Tolvaptan

ADH recetor antagonist in CD
Increase free water loss

13

Carbonic Anhydrase Inhibitor
Example, Uses (3) and Adverse Effects (3)

Acetazolamide

Treats:
Metabolic alkalosis
Glaucoma
Acute Mountain Sickness

Causes:
Hypokalemia
Hyperchloremic acidosis
Nephrolithiasis

14

Osmotic Diuretic
Example, MOA, Uses (3)

Mannitol

Unable to be reabsorbed so it traps water to cause diuresis

Kidney Failure Prophylaxis
Decreases Intracranial and Intraocular pressure

15

Which two diuretic classes are contraindicated in pregnancy?

Loop Diuretics
Thiazide Diuretics