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Diuretics Flashcards

1
Q

Diuretics is

A

The agents or drugs that increase urinary volume along with salt and electrolytes

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2
Q

Classification

A

Acc to site of action
Acc to potency

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3
Q

Acc to site of action

A

I) PCT
II) thick ascending loop of henle
III) DCT
IV) Collecting duct

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4
Q

PCT

A

Carbonic anhydrase : ACETAZOLAMIDE BRINZOLAMIDE DORZOLAMIDE. METHOZOLAMIDE

Osmotic diuretic. : Mannitol. Urea. Glucose Isosorbide

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5
Q

LOOP DIURETICS

A

Frusemide
Bumatanide
Torsemide
Ethacrynic acid

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6
Q

Thiazide diuretics

A

HYDRO CHLORO THIAZIDE
CHLORO THIAZIDE
POLY THIAZIDE
CYCLO PEN THIAZIDE
CHLOR THALIDONE
INDA PAMIDE

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7
Q

K+ sparing drugs

A

Spironolactone
Amiloride
Triamterene

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8
Q

Acc to potency

A

High potency / ceiling diuretics ( loop diuretics )
Moderate efficacy ( Thaizide )
Low efficacy : spironolactone mannitol acetazolamide

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9
Q

Indications of diuretics / frusemide

A

Oedema due to NS CCF
ALVF
ACUTE PULMONARY OEDEMA
ARF
Hyperkelemia
Hypercalcemia
As AHTN drug
Glaucoma
Cerebral oedema

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10
Q

Indications of diuretics / frusemide

A

Oedema due to NS CCF
ALVF
ACUTE PULMONARY OEDEMA
ARF
Hyperkelemia
Hypercalcemia
As AHTN drug
Glaucoma
Cerebral oedema

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11
Q

Loop diuretics // high ceiling diuretics

A

Blocks Na+-K+ - 2Cl- symporter in TAL of LOH

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12
Q

Why are loop diuretics called high ceiling diuretics

A

They cause forceful diuretics
Effective even after GFR below 10ml/min
They excrete 25% filtered Na+
They have rapid onset of action
Increase diuretic action with increasing dose

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13
Q

M/A of frusemide

A

Acts on thing ALLH

Inhibits Na+ K+ 2Cl- symporter => urinary excretion with electrolytes ==> diuresis

Increase renal blood flow ==> diuresis

(-) carbonic anhydrase ==> (-) HCO3- reabsorption ==> HCO3 excretion ==> diuresis

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14
Q

M/A of hydrochlorothaizide

A

Acts on DCT

(-) Na+-Cl- co- transport mechanism

(-) re absorption of Na+ and Cl-

Increase excretion of water and electrolytes

Diuresis

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15
Q

M/A of spironolactone

A

Binds with MINERALCORTICOID RECEPTOR

Forming a complex

This complex binds with DNA

(-) transcription and translation

(-) Na+ pump

No reabsorption of Na+

Diuresis with no loss of K+

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16
Q

Indications of frusemide

A

Oedema ( due to NS , CCF)
ALVF
Acute pulmonary oedema
Hyperkelemia
Hypercalcemia
As Anti HTN drug

17
Q

A/E of frusemide

A

Hypotension

Loss of electrolytes ==> Hyponatremia Hypokelemia Hypocalcemia Hyperuricemia

Hyperglycemia

OTOTOXICITY
Headache
Dizziness
Xanthopsia
Libido

18
Q

Contraindications

A

Hypovolume
Hypotension
Pregnancy
Liver cirrhosis

19
Q

Thiazide criteria

A

GFR should be more than 20ml/min
Excrete 5-10 % filtered Na+

20
Q

Thiazide criteria

A

GFR should be more than 20ml/min
Excrete 5-10 % filtered Na+

21
Q

Indications of thiazide

A

Hypertension
CCF
Nephrolithiasis
Oedema due to NS CCF
Osteoporetic patient
Nephrogenic diabetic insipidus

22
Q

Indications of thiazide

A

Hypertension
CCF
Nephrolithiasis
Oedema due to NS CCF
Osteoporetic patient
Nephrogenic diabetic insipidus

23
Q

A/E of thiazide

A

Hypotension

Loss of electrolytes

Hypokelemia hyponatremia hypomagnesemia hypocalcemia

Hyperuricemia
Hyperglycemia
Metabolic alkalosis
Hypercholestroremia

24
Q

Contraindications of thiazide

A

Hepatic and renal failure
DM
Gout

25
Anti hypertensive role of hydrocholoro thiazide
HTZ (-) Na + Cl- co transport mechanism Increase excretion of electrolytes and water Decrease blood volume Decrease venous return Decrease CO Decrease BP
26
Why thiazide is 1st line anti hypertensive drug
Anti hypertensive action occurs at low dose Thiazide causes passive vasodilation by reducing the sensitivity of blood vessels to circulating catecholamines Thiazide has advantage of minimising the retention of salt and water and causes diuresis without acid base imbalance
27
Clinical uses of acetazolamide
Glaucoma Metabolic alkalosis Epilepsy Hyperkelemia Urinary alkalisation in aspirin poisoning
28
M/A of acetazolamide
(-) carbonic anhydrase enzyme Decrease Na+ and HCO3 reabsorption from PCT Increase excretion of electrolytes and water Diuresis
29
Indications of osmotic diuretics
Reduce ICP , cerebral Oedema To produce diuresis Glaucoma Prevention of renal tubular necrosis For gut sterilisation before operation orally
30
Contraindications of mannitol
Anuria Cerebral hemmorhage Dehydration
31
K + sparing drugs indications
Oedema with HTN Given with K+ loosing diuretics Oedema with cirrhosis of liver Primary hyperaldosterenism Secondary hyperaldosterenism
32
A/E of spironolactone
HYPERKELEMIA GYNAECOMASTIA IN MALE HIRSUTISM IN Female Amennorhea Metabolic acidosis Deepening of voice Impotency Rash Gastritis
33
CONTRAINDICATIONS of spironolactone
Hyperkelemia ARF PUD Liver disease PUD Headache

Pharmacology (21 decks)

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