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Diuretics Flashcards

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1
Q

Thiazide & T like diuretics name ??

A
  1. chlorthiazide
    chlorthalidone
    hydro-chlorthiazide
    metolazone
    indapamide
    Bendro & Hydro Flumethiazide

318

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2
Q

Loop D name ??

A

frusemide
torsemide
ethacrynic acid
bumetanide

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2
Q

T diuretics site ??

A

DCT
block Na Cl transporter

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3
Q

L D site ??

A

thick ascending limb of loop of henle

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4
Q

K sparing D name ??

Aldosterone receptor antagonists namne ??

A

spironolactone
eplerenone

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5
Q

K sparing drugs site >??

A

C T

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5
Q

Na channel blockers anem ??

a

A

amiloride
triamterene

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6
Q

carbonic anhydrase inhibitors name ??

A

Aceta-dorzo-metha-brin–ZOLAMIDE

319

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7
Q

CAI site ??

A

PCT

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8
Q

SGLT-2 name ??

A

empagliflozin
cana-dapa=gliflozin

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9
Q

Osmotic D name ??

MUI Gu

A

mannitol
urea
inulin
glucose

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10
Q

high efficacy D name ??

A

Loop D `

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11
Q

why high efficacy ??

A
  • high dose = increase diuresis effect
    25% filtered Na to be excreted
    Block Na K 2 Cl channel

322

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12
Q

M/A of loop D ??

A

322

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13
Q

Indications of Loop D ??

A

HF
acute pulmonary edema
& other edematous condition
hypercalcaemia
hyperkalaemia
anion overdose
acute renal failure

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14
Q

A/E of Loop D ??

A

Hyperuricemia
Hypovolemia
Hypokalaemia
H Metabolic alkalosis
Ototoxicity
Hypo-Mg & Ca
allergic reaction

324

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15
Q

A/E of T D ??

A

Hyponatremia
Hypokalemia
other- HYPER

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15
Q

contraindication of Loop D ??

A

HF
RF
Heaptitic cirrhosis

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16
Q

ALVF & CCF physiology ??

A

=pulmonary congestion
=edema
impair oxygenation
=rrespiratory distress

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17
Q

why gout after Frusemide ??

A

hypovolemia
inc absorption of uric acid in PCT

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18
Q

Indications of T diuretics ??

A

HTN
HF
nephrolithiasis due to idiopathic hypercalciuria
nephrogenic DI

326

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19
Q

M/A of T D ??

A

326

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20
Q

T +Spironolactone = ??

A

T = hypokalaemia
S = hyperkalaemia

pharmacological potentiation

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21
Q

T + ARB = ??

A

Same

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22
T + CCB = ??
Both Anti-HTN drugs
23
why Hyponatremia ??
328
24
why Hypokalaemia in T D ??
329
25
Why T diuretics in kidney stone ??
330
26
T like analogue ??
lack of T structure - sulfonamide group present + same M/A | 330
27
Indications of Spironolactone ??
* HF HYPERALDOSTERISM diuretics
28
spironolactone M/A ??
333
29
types of hyperaldosterinism ??
primary - conns syndrome ' secondary - HF liver cirrhosis nephrotic syndrome | 333
30
spironolactone effect on CT ??
N excretion K H retention ## Footnote 333`
31
A/E of spironolactone ??
hyperkalemia endocrine abnormality PUD Hyperchloremic metabolic acidosis gynecomastia impotence BPH Mnestrual irregulrity kidney stone skin rashes CNS Adverse effect | 334
32
which one doesnot cause gynecomastia >?
eplernone | 334
33
indication of acertazolamide ??
glaucoma' metabolic alkalosis urinary alkalization acute moiuntain sickness epilepsy
34
osmotic D M/A ??
1. inc conc of osmotically active molecules inc osmolarity of tubular fluid in PCT INC osmotic pressure dec H2O reabsorption diuresis
35
indications of osmotic D ??
inc urine volume reduction ICranial P reu]duction IOP | 338
36
Mild to Moderate which D ??
Spironolactone
37
chronic HTN drug ??
Thiazide
38
why not frusemide in chronic HTN ??
Chronic HTN - e sob hypo hote hote Hypotension e pt mara jabe
38
cerebral in jury te edema dec korar jonno which D >??
Osmoptic D
39
Which D preganancy safe >?/
T
39
Digoxin + Diuretics = ??
T+Loop + D = Digoxin toxicity D+ spironolcatone = can be used D toxicity = precipitate D toxicity
40
Alkalosis by which D >>>
T + Loop
41
other glaucoma drugs >
dec aquous secretion -diuretics -beta blockers -selective alpha-2 blockers inc A secretion -prostaglandin -cholinomimetic
42
Management of hypokalemia ?
stop the drug K sparing diuretics should be used correct hypovolemia K containing foods - banana guava green cocnut
43
which prostgalndin analogous in glaucoma PROF
Latano-Bimato-Travo=PROST 698
44
Which D in hyperkaemia pt ?
spironolactone
45
jar K level normal take kon D >
T LD
46
renal disease e kon diuretics
T LD
47
Frusemide which hypersensitivity?
anaphylactic
48
HTN emergency which D ?
Loop diuretics
49
thiazide M/A of Nephrogenic DI ?
🔹 **Thiazide Diuretics 🏜️ Nephrogenic DI - MOA** 1️⃣ **Blocks Na+/Cl- symporter** → **⬇ Na+ reabsorption** (DCT) 2️⃣ **⬇ ECF volume** → **⬆ RAAS activation** 3️⃣ **⬆ Proximal Na+/H2O reabsorption** (PCT compensatory) 4️⃣ **⬇ Distal delivery of filtrate** → **⬇ Urine output** 5️⃣ **⬆ Aquaporin expression** (via ⬆ ADH sensitivity) 6️⃣ **⬇ GFR** → ⬆ Tubular fluid contact time → ⬆ Water reabsorption 🛑 **Final Effect:** ⬆ Urine osmolality, ⬇ Polyuria @usmlereviews
50
which one in hypertensive emergency >
🔹 **Diuretic for Hypertensive Emergency (📖 Katzung)** ✅ **Loop Diuretics (Fast-acting, potent)** - **Ex:** **Furosemide, Bumetanide, Torsemide** - **MOA:** Inhibits Na+/K+/2Cl- (TAL) → **⬇ Volume, ⬇ Preload & Afterload** - **Use:** **HTN Emergency + Volume Overload (CHF, CKD, Pulmonary Edema)** - **Effect:** Rapid **venodilation** (↓ preload) + **diuresis** 🛑 **Thiazides & K+-sparing diuretics NOT used** (slower onset) 📖 Ref: **Katzung's Basic & Clinical Pharmacology** @usmlereviews
51
why indapamide is more in use ?
🔹 **Why Indapamide > Other Thiazides? (📖 Katzung)** ✅ **Longer Half-life** → **Once-daily dosing** (⬆ Compliance) ✅ **More Potent** than HCTZ → **Better BP control** ✅ **No Significant ⬆ in Lipids** (Unlike HCTZ) ✅ **⬆ Vasodilation** (Ca2+ channel modulation → ⬇ PVR) ✅ **Renal-sparing** in **CKD** (Less GFR reduction than other thiazides) ✅ **Less Hypokalemia & Hyperglycemia** (Metabolically neutral) 📖 Ref: **Katzung's Basic & Clinical Pharmacology** @usmlereviews
52
why indapamide in use ?
significant anti-HTN effect with minimum diuretic effect excreted and metabolized by GI & kidney | 331
53
mild HTN ?
T 331
54
which one in HF ?
frusemide
55
M/A of frusemide in HF ? | 406
dec venous pressur e dec ventricular preload reduction of cardiac size
56
🔹 **Polyuria in 🍬 Diabetes Mellitus - Exact MOA** 1️⃣ **⬆ Plasma Glucose (>180 mg/dL)** → **Exceeds SGLT2 Capacity** (PCT) 2️⃣ **Glucosuria** → **⬆ Tubular Osmolarity** 3️⃣ **Osmotic Gradient** Prevents H2O Reabsorption (PCT & CD) 4️⃣ **⬆ Urine Output (Polyuria)** → ⬆ Na+/K+ Excretion 5️⃣ **Hypovolemia** → **⬆ Thirst (Polydipsia)** via Hypothalamic Osmoreceptors 🛑 **End Effect:** Volume Depletion, Hyperosmolarity, ⬆ ADH Release 📖 Ref: **Katzung's Basic & Clinical Pharmacology** @usmlereviews
lllllll
57
different failure diuretics name ?
🔹 **Diuretics for Organ Failures (📖 Katzung)** ✅ **Liver Failure (Cirrhosis, Ascites)** - **Spironolactone, Eplerenone** (Aldosterone Antagonists) → **⬇ Na+/H2O retention** - **Furosemide (Adjunct, if severe ascites)** ✅ **Renal Failure (CKD, AKI, Nephrotic Syndrome)** - **Loop Diuretics (Furosemide, Torsemide, Bumetanide)** → **⬆ Na+/H2O excretion** - **Metolazone** (Synergistic with loops in CKD) ✅ **Heart Failure (HFrEF, HFpEF)** - **Loop Diuretics (Furosemide, Torsemide)** → **⬇ Preload, Pulmonary Edema** - **Spironolactone, Eplerenone** → **⬇ Mortality (Anti-aldosterone)** 📖 Ref: **Katzung's Basic & Clinical Pharmacology** @usmlereviews
58
How to reduce hyponatremia in Thiazide ?
reduce dose of the drug + limiting water intake `
59
why Hyponatremia in Thiazide drug >
elevations of ADH inc thirst reduce in the diluting capacity of the kidney
60
ARB + Thiazide = ?
1.minimize A/E 2.pharmacological potentiation
61
how to inc druation of action of Thiazide >
T + secondary acting - digitalis alkaloids
62
T + CCB = ?
good control of BP
63
Drug resistant HTN = Tx ?
spironolactone
64
Management of T induced hypokalemia /
stop the drug K sparing drugs banana guava green coconut
65
Hyperurecemia by T ?
inhibit uric acid secretion
66
Hypokalemia by T ?
329
67
can T be used in emergency HTN ?? why ? why not /
T - duration of action prolonged -- 10-12 hr
68
indapamide ??
lipid soluble non-thiazide diuretics
69
Metabolism & excretion of indapamide <
GIT & kidney
70
which Loop D is not sulfonamide ?
ethacrynic acid
71
why ototoxicity in Loop D <
inhibition of symport mechanism in the endolymph
72
which one is emergency Diuretics /
loop 2-3 min
73
why metabolic acidosis in spironolactone /
inhibition of H secretion
74
why endocrine abnormality in spironolactone ?
steroid receptors actions
75
male manifestation ?
impotence BPH gynecomastia
76
female manifestation >
mens irregularity 24.2.2025 2.10AM

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