Diuretic Pharm

Question 1

Sites of reabsorption in kideny

Answer 1

proximal tubule: 60-65% Na+ reabsorbed
loop of Henle: 25% Na+ reabsorbed
distal convoluted tubule: 3+% Na+ reabsorbed

Question 2

carbonic anhydrase inhibitors

Answer 2

acetazolamide (diamox)
MOA: prevents exchange of H+ ions with Na+
SOA: PCT
Indications: Edema management, pulmonary function mountain climbing
AE: metabolic acidosis, drowsiness, anorexia…

Question 3

loop diuretics

Answer 3

furosemide (lasix), ethacrynic acid (edecrin)
MOA: inhibit Na+ and Cl- reabsorption; increase in renal protoglandins, resulting in vasodilation
SOA: Ascending loop of Henle
Indications: CHF, heart failure with edema
AE: ototoxicity, hypokalemia, hyperglycemia, hyperuricemia

Question 4

thiazide diuretics

Answer 4

hydrochlorothiazide (HCTZ) chlorthalidone (Hygroton)
MOA: inhibits tubular reabsorption of NA+/CL- resulting in increased h20 and na excretion
SOA: ascending loop of Henle and early DCT
Indications: HTN, edematous states
Most common drug for HTN

Question 5

potasium sparring diuretics

Answer 5

spironolactone (Aldactone)
MOA: interferes with Na+/K+ exchange competitively binds to aldosterone receptors
SOA: Collecting ducts and DCT
Indications: chronic liver disease, ascites,

Question 6

osmotic diuretics

Answer 6

mannitol (osmitrol)
MOA: inhibits H2O and Na+ reabsorption
SOA: PCT and loop of henle
Indications: crush injuries, need to increase GFR
AD: dehydration
Not a very good diuretic, never use in HTN pt.

Question 7

calcium channel blocking agents (CCB)

Answer 7

inhibit Ca+ influx, create dilation iof coronary and peripheral arteries

• dihydropyridines
• phenylakylamines
• benzothiazepines

Question 8

angiotension coverting enzyme (ACE) inhibitors

Answer 8

lisinopril (zestril)

Question 9

angiotensin receptor blockers (ARB)

Answer 9

valsartan (Divoan), losartean (Cozaar)
block angiotensin AT1 receptors, inhibition of aldosterone
-dialates veins and ateries, increases renal excretion

Question 10

renin inhibitors

Answer 10

inhibit renin, which stimulates angiotensin 2 formation

Question 11

centrally acting sympatholytics

Answer 11

clodidine, methyldopa

- sympathetic activity by bind to and activating alpha 2

Question 12

direct vasodilateors

Answer 12

nitroglycerin, hydralazine

HTN emergencies and preeclampsia

Question 13

phosphodiesterase inhibitors

Answer 13

sildenafil (viagra)

vasodilation of arterial beds in corpora cavernosa