Diuretics

Question 1

Thiazide diuretics

Answer 1

Hydrochlorothiazide chlorthalidone indapamide

Question 2

Secreted from OASS in PCT

Answer 2

Thiazide
*uric acid too (why they fight in the first place)
*some antibodies
*loop diuretics

Question 3

Inhibits thiazide

Answer 3

Probenecid

Question 4

Loop
*high efficacy rapid onset and short duration

Answer 4

Frisemide and Torsemide (Sulfonamides)
Ethacrynic acid(Non Sulfonamides)

Question 5

Also antagonised by probenecid and also decrease uric acid excretion

Answer 5

Loop diuretics

Question 6

Thick Ascending Limb
For Na K Cl cotransport

Answer 6

Loop

Question 7

Ototoxic - to hair cells of the inner ear

Answer 7

Loop - deafness and hearing defect especially with otoyoxic drugs like gentamicin

Question 8

Fetotoxic

Answer 8

Thiazide and loop contraindications
Together with kidney and liver failure, digitalis toxicity(hypok), corticos, pregnancy and gout

Question 9

Mild and moderate hypertensive

Answer 9

Thiazide

Question 10

Other antihypertensive vaso dilators

Answer 10

Hydralazine and minoxidil (inhibit salt and water retention)

Question 11

Useless when GTR is less than 30

Answer 11

Thiazide
Use loop

Question 12

Na channel blocker

Answer 12

K channel opener

Question 13

Thiazide for HF

Answer 13

When body doesn’t respond to loop

Question 14

Jmpairs release of insulin causing hyperglycemia

Answer 14

Thiazide adverse effect

Question 15

Powerful diuretic effect

Answer 15

Loop diuretics

Question 16

Decreases net positive potential for Ca and Mg reabsorption

Answer 16

Frusemide

Question 17

Can be used even when GFR less than 10

Answer 17

Loop

Question 18

Loop is ideal for hypertension

Answer 18

But it’s short duration of action makes it disadvantageous
*used in oedemas too
*and hypercalcemia not hypo (because it inhibits common carrier preventing Ca influx through net positive created by K

Question 19

Loop treatment of hylercalcemia

Answer 19

Furosemide plus electrolyte replacement plus IV

Question 20

Ototoxicity (damafes hair cells of the inner ear) of Aminoglycosides e.g.

Answer 20

Gentamicin.

Question 21

Fruit juice

Answer 21

Counteract hypokalemia thiazide adverse effects (that worsens digitalis toxicity)
*k retaining diuretic like spironolactone

Question 22

Thiazide helps idiopathic hypercalcuria, stones or osteoporosis

Answer 22

As it prevents Ca from being excreted - hyoercalcuria

Question 23

Thiazide in heart failure (loop is still better)

Answer 23

Diuresis - for the systemic oedema
Arterial VD - decreased TPR decreasing preload

Question 24

Frusemide plus wrfarin

Answer 24

Displaces it from plasma protein binding site

Question 25

Why thiazide useful in subdiuretic doses as an antihypertensive

Answer 25

It's diuresis doesn't really contribute much Majorly its VD properties

Question 26

*release prostacyclin *depletes Na from arterial wall *hyperpolarisation; k channel opener

Answer 26

VD properties of thiazide

Question 27

NSAIDS with thiazide contraindicated

Answer 27

Antagonizes antihypertensive prostacyclin

Question 28

Thiazide in oedema

Answer 28

Cardiac Hepatic Renal Pre menstrual tension syndrome

Question 29

Frusemide plus lithium carbonate

Answer 29

Decreases renal clearance

Question 30

Frusemide plus Aminoglycosides like gentamicin

Answer 30

Increases Ototoxicity

Question 31

Frusemide plus Aminoglycosides and cephalosporins

Answer 31

Nephrotixicopty

Question 32

Decreases diuretic effect of frusemide

Answer 32

NSAIDs decreasing Prostaglandin

Question 33

Potassium Retaining Diuretics *weak (low efficacy diuretics)

Answer 33

Competitive antagonists of aldosterone - spironolactone eplerelenone finerenone Direct inhibitors of Na influx in CCT - triamterene amiloride

Question 34

Refractory oedema from CHF plus essential hypertension plus polycystic ovary sundrome

Answer 34

Spironolactone

Question 35

HF *decreases remodelling and improves Perfusion

Answer 35

Eplerenone and finerenone

Question 36

Effective in cases of hyperaldosteronism

Answer 36

Competitive antagonists like spironolactone as they fight for its receptors causer hypoNa hyper K and hypoH

Question 37

Chronic Kidney disease

Answer 37

Finerenenorone

Question 38

Spironolactone with thiazide and loop

Answer 38

To synthergize effect and correct hypokalemia

Question 39

Less hyperkalemia

Answer 39

Fienrenone - decreased tendency to accumulate in kidneys

Question 40

Weak diuretic K Retaining

Answer 40

And slow onset 2 - 3 days

Question 41

Eplerenone and finrenone

Answer 41

More selective than spironolactone so not as much side effects (angmdrogen thing, progesterone, Glucocorticoids)

Question 42

Osmotic diuretics *Taken IV in emergencies

Answer 42

Mannitol Not metabolised. Not active. Non toxic.

Question 43

Inhibits water reabsorption so increases urine

Answer 43

Mannitol

Question 44

Therapeutic uses of mannitol

Answer 44

Oedema in tissues (lowers intracranial and IO P In acute reanl failure

Question 45

No mannitol in pulmonary oedema

Answer 45

Blood from lungs taken to bvs return to lungs again

Question 46

Oral mannitol

Answer 46

Diarrhea - increases osmotic pressure in GIT which draws water in the food and all

Question 47

Carbonic Anhydrase inhibitors *In PCT as that's where 85 to 90 % obicarbonate is reabsorbed

Answer 47

Acetazolamide Dorzolamide

Question 48

Carbonic AI weak because

Answer 48

Decreases bicarbonate in blood increases NaCl reabsorption in rest of nephron *severe metabolic acidosis still

Question 49

Increased bicarbonate

Answer 49

Increases Stone formation

Question 50

Dorzolamide orally or as eye drops

Answer 50

Open angle glaucoma to decrease aqueous humour production

Question 51

Dorzolamide IV

Answer 51

Closed angle glaucoma

Question 52

Another weak diuretic More for diabetes (3rd line)

Answer 52

SGLT2 Inhibitors *Dapagliflozin *Cangliflozin in 206 textbook

Question 53

Adverse effect of dapagliflozin

Answer 53

UTI because glucose fermentation and all

Question 54

Spironolactone antagonizes

Answer 54

Digitalis in HF and carbenoxolone jn peptic ulcer