Diuretics

Question 1

osmotic diuretics

Answer 1

eg mannitol, urea

poorly reabsorbed, so sucks water into tubules, reducing water reabsorption.
Hypertonic dehydration: Water rather than Na
excreted
For localised oedema
– Raised intracranial pressure or
– Glaucoma

Question 2

Acetazolamide

Answer 2

carbonic anhydrase inhibitor
inhibit H+ secretion and HCO3- reabsorption
reducing Na+ reabsorption

not for generalized oedema, more for specialised things like glaucoma

Question 3

frusemide

Answer 3

inhbits Na+/K+/2Cl-
reducing na n water reabsoprtion in thick ascending limb

(also inhibiting K+ reabsroption)
AE: hypokalaemia
rash
hyperuricaemia +gout 
hypercholesterolemia

Question 4

drug interactions with frusemide n hydrochlorothiazide

Answer 4

DIGOXIN
aminoglycosides
warfarin
ace inhibitors

Question 5

hydrocholorthiazide

Answer 5

inhibits Na+/Cl- carrier, reducing reabsorption of Na+ in early distal convoluted tubule.

decrease calcium excretion

SE: hypokalaemia
hyperglycaemia bla bla

NEVER USE IN chronic renal Failure – HYPERKALEMIC ALREADY

Question 6

thiazide drugs:

Answer 6

Hydrochlorothiazide
• Chlorthalidone
• indapamide

Question 7

potassium sparing diuretics classes

Answer 7

1. aldosterone anatagonist- drug= spironolactone

2. sodium channel blockers e.g. amiloride

Question 8

spironolactone

Answer 8

aldosterone antagonist
inhibits Na+/K+ ATPase in collecting tubule. decrease Na reabsrotpion, decreease K+ secretion

SE: hyperkalaemia
– decreased libido, impotence
– menstrual disturbances
can cause gynecomastia

Question 9

amiloride

Answer 9

blocks Na+ channels
decrease na reabsorption

AE: hyperkalaemia

Question 10

AVOID ACEI/ARB + _________ (HYPERKALEMIA)

Answer 10

AVOID ACEI/ARB + POTASSIUM SPARING DIURETIC (HYPERKALEMIA)