Diuretics

Question 1

What is the general physiological outcome of diuretics?

Answer 1

Increased urine output by decreasing the reabsorption of sodium (Na+), chloride (Cl-), bicarbonate (HCO3-), or other ions.

Question 2

How do diuretics promote water excretion?

Answer 2

By increasing the excretion of specific ions, changing osmotic balance.

Question 3

What is the primary mechanism of diuretics?

Answer 3

They act on different parts of the nephron to inhibit ion transport, reducing water reabsorption.

Question 4

How do diuretics help in Nephrotic Syndrome?

Answer 4

They reduce fluid retention caused by albumin loss.

Question 5

What condition does diuretic use improve in Congestive Heart Failure (CHF)?

Answer 5

Reducing blood volume.

Question 6

What is the role of diuretics in Renal Failure?

Answer 6

They prevent excess sodium retention.

Question 7

How do diuretics help in Hepatic Cirrhosis?

Answer 7

They reduce ascites (fluid in the peritoneal cavity).

Question 8

How do diuretics help in Hypertension?

Answer 8

They lower blood pressure by reducing blood volume.

Question 9

What effect do diuretics have on Nephrolithiasis (Kidney Stones)?

Answer 9

Thiazides reduce calcium in urine, preventing stone formation.

Question 10

How are diuretics used in Hypercalcemia?

Answer 10

Loop diuretics increase calcium excretion.

Question 11

How do diuretics help in Nephrogenic Diabetes Insipidus (NDI)?

Answer 11

Thiazides reduce excessive urine production.

Question 12

What are the therapeutic uses of diuretics?

Answer 12

Edematous state (fluid retention)
- CHF
- Kidney disease
- Hepatic cirrhosis
- Idiopathic edema
Non-Edematous state (no fluid retention)
- Hypertension
- Kidney Stones
- Hypercalcemia
- NDI

Question 13

Where does the initial ultrafiltration occur in the nephron?

Answer 13

Glomerulus.

Question 14

Which diuretics act on the Proximal Tubule?

Answer 14

Osmotic diuretics and carbonic anhydrase inhibitors.

Question 15

What part of the nephron is targeted by loop diuretics?

Answer 15

Loop of Henle (Thick Ascending Limb).

Question 16

Which diuretics act on the Distal Convoluted Tubule?

Answer 16

Thiazide diuretics.

Question 17

Which diuretics target the Collecting Duct?

Answer 17

Potassium-sparing diuretics.

Question 18

Name two osmotic diuretics.

Answer 18

Mannitol (Osmitrol®), Urea (Ureaphil®).

Question 19

What is the mechanism of osmotic diuretics?

Answer 19

Increases osmolarity of tubular fluid, preventing water reabsorption.

Question 20

What is the effect of osmotic diuretics?

Answer 20

Increased excretion of water and some electrolytes.

Question 21

What are the therapeutic uses of osmotic diuretics?

Answer 21

Acute renal failure, reduction of intracranial pressure, excretion of toxic substances.

Question 22

Name three carbonic anhydrase inhibitors.

Answer 22

Acetazolamide (Diamox®), Dichlorphenamide (Daranide®), Methazolamide.

Question 23

What is the mechanism of carbonic anhydrase inhibitors?

Answer 23

Inhibits carbonic anhydrase, decreasing HCO3- reabsorption and reducing Na+/H+ exchange, reducing Na+ reabsorption

Question 24

What is the effect of carbonic anhydrase inhibitors?

Answer 24

Increased excretion of Na+, HCO3-, and water (weak action) bascially decrease the reabsorption

Question 25

What are the uses of carbonic anhydrase inhibitors?

Answer 25

Glaucoma, acute mountain sickness, metabolic alkalosis, epilepsy.

Question 26

Name four loop diuretics.

Answer 26

Furosemide (Lasix®), Bumetanide (Bumex®), Ethacrynic Acid (Edecrin®), Torsemide (Demadex®).

Question 27

What is the mechanism of loop diuretics?

Answer 27

Inhibits Na+/K+/2Cl- co-transporter (NKCC2), reducing reabsorption of Na+, Cl-, Ca++, and Mg++.

Question 28

What is the effect of loop diuretics?

Answer 28

Increased excretion of Na+, Cl-, Mg++, and Ca++.

Question 29

What are the uses of loop diuretics?

Answer 29

Edema (CHF, hepatic, renal disease, ascites), hypertension, hypercalcemia.

Question 30

Name two thiazide diuretics.

Answer 30

Hydrochlorothiazide (Hydrodiuril®), Chlorothiazide (Diuril®).

Question 31

What is the mechanism of thiazide diuretics?

Answer 31

IInhibits Na+/Cl- co-transporter (NCCT), increases calcium reabsorption.

Question 32

What is the effect of thiazide diuretics?

Answer 32

Increased excretion of Na+ and Cl-, increased calcium reabsorption.

Question 33

What are the uses of thiazide diuretics?

Answer 33

Hypertension adjunct therapy for CHF nephrogenic diabetes insipidus kidney stone prevention

Question 34

Name two types of potassium-sparing diuretics.

Answer 34

Aldosterone Antagonists (Spironolactone), Sodium Channel Blockers (Triamterene, Amiloride).

Question 35

What is the mechanism of aldosterone antagonists?

Answer 35

Block aldosterone receptors, reducing Na+ reabsorption and K+ excretion.

Question 36

What is the effect of aldosterone antagonist potassium-sparing diuretics?

Answer 36

Increased Na+ excretion, decreased K+ excretion.

Question 37

What is the mechanism of sodium channel blockers?

Answer 37

Directly inhibit Na+ channels in the collecting tubule. (decreased Na+ absorption)

Question 38

What are the uses of potassium-sparing diuretics?

Answer 38

Used with loop or thiazide diuretics to prevent K+ loss, hypertension, and heart failure.