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Flashcards in Diuretics Deck (30):
0

Drugs that modify salt excretion

Acetazolamide
Furosemide
Thiazides
Spironolactone
Mannitol

1

Drugs that modify water excretion

Desmopressin
Conivaptan
Mannitol

2

Site of uric acid transport and osmotic diuretics
Major site for NaCl and NaHCO3 reabsorption
Site of action of Carbonic Anhydrase inhibitors

PCT

3

Reduces secretion of aqueous humor in glaucoma
Metabolic acidosis increases respiration in mountain sickness
SE: NAGMA, Hep Enceph in Pxs with cirrhosis

Drug, class

Acetazolamide, Carbonic anhydrase inhibitor

ACIDazolamide

4

Causes of HAGMA

MUDPILES

Methanol
Uremia
DKA
Paraldehyde, Propylene glycol
Isoniazid
Lactic acid
Ethanol, ethylene glycol
Salicylates

5

Causes of NAGMA

HARDUP

Hyperalimentation
Acetazolamide
RTA
Diarrhea
Ureteral Diversion
Pancreatic Fistula

6

These drugs decrease the efficacy of Loop diuretics

NSAIDs

7

Site of action of loop diuretics
Site of Ca and Mg reabsorption

TAL of Loop of Henle

8

Half life of Furosemide

6 hours

9

Inhibits Na/K/2Cl transporter in thick ascending limb of loop of henle
Causes powerful diuresis and Ca excretion
Drug for pulmonary edema, hyercalcemia, ARF
SE: dehydration, ototoxicity, sulfa allergy, hypocalcemia, hypomagnesemia, hyperuricemia

Drug, Class

Furosemide, Loop diuretic
(Bumetanide, Torsemide, Ethacrynic acid)

10

Drug with synergistic ototoxicity with aminoglycosides
Efficacy decreased by NSAIDs

Drug, Class

Furosemide, Loop diuretic

11

Loop diuretic toxicities

OH DANG!
Ototoxicity
Hypokalemia
Dehydration
Allergy to Sulfa
Nephritis
Gout

12

Site of action of thiazide diuretics
Actively pumps Na and Cl via Na/Cl carrier
Site of Ca reabsorption secondary to PTH

DCT

13

Calcium is also reabsorbed in the DCT due to ___.

PTH

14

Inhibits Na/Cl transporter in the DCT
Causes modrate diuresis and reduce Ca excretion
Drug for HPN, Nephrogenic DI
SE: HyperGLUC

Drug, Class

Hydrochlorothiazide, Thiazide diuretic
(Chlorthalidone, Indapamide, Metolazone)

15

Drug with synergistic effect with loop diuretics
Efficacy is decreased by NSAIDs

HCTZ

16

Last site for Na reabsorption, K excretion
Under the influence of aldosterone
Primary site for urine acidification
Site of K-sparing diuretics

Cortical Collecting Duct

17

Potassium sparing diuretics:

SEAT PO
Spironolactone
Eplerenone
Amiloride
Triamterene
POtassium

18

Steroid inhibitors of cytoplasmic aldosterone receptor in CCD
Reduces K excretion
Drug for hyperaldosteronism, hypoK, HPN
SE: gynecomastia, hyperK

Drug, Class

Spironolactone, Potassium-Sparing Diuretic (Aldosterone antagonist)
(Eplerenone)

19

Diuretic that reduces progression of DM nephropathy and reduces mortality post-MI

Drug, Class

Eplerenone, Potassium-Sparing Diuretic

20

Drug that inhibits ENaC epithelial sodium channels in CCD
Reduces Na reabsorption and K excretion
Drug for hypokalemia
SE: hyperK, ARF, Kidney stones
Should NEVER be given with K supplements

Drug, Class

Amiloride, Potassium-Sparing Diuretic
(Triamterene)

21

Drugs that cause Gynecomastia

Some Drugs Create Awesome Knockers
Spironolactone
Digoxin
Cimetidine
Alcohol
Ketoconazole

22

Drugs that reduce reabsorption of water in the descending limb of the loop of henle and Collecting tubule
Used for increased ICP, acute glaucoma
SE: transient volume expansion

Drug, Class

Mannitol, Osmotic diuretic
(Glycerin, Isosorbide, Urea)

23

Site of action of ADH agonists and antagonists
Site of water reabsorption secondary to ADH

Medullary Collecting Duct

24

Agonist at V1/V2 ADH Receptors
Inserts aquaporins in the collecting tubule
Drug for Central DI
SE: hyponatremia, hypertension

ADH, ADH Agonist
(Vasopressin, Desmopressin)

25

Antagonist at V1a, V2 receptors
Drug for SIADH
SE: nephrogenic DI, infusion site reaction
Central Pontine Myelinosis may occur with rapid correction of hyponatremia

Conivaptan, ADH Antagonist
(Tolvaptan, Lixivaptan, Demeclocycline, Lithium)

26

Identify the drug:
Increases Urine Na, K, HCO3
Blood pH: Acidosis

Acetazolamide

27

Identify the drug:
Increases Urine Na, K, Ca, Mg, Cl
Blood pH: Alkalosis

Furosemide

28

Identify the drug:
Increases Urine Na, K, Cl, Ca
Blood pH: Alkalosis

HCTZ

29

Identify the drug:
Increases Urine Na (small), Decreases Urine K
Blood pH: Acidosis

Spironolactone