Flashcards in Diuretics Deck (36)
What drugs are used to treat acute closed angle glaucoma?
Carbonic anhydrase inhibitor and beta blocker
Which 2 group of drugs should not be used with pt with closed angle glaucoma?
Anti M and alpha 1 agonist
What are the 2 ways of treating glaucoma and what drugs are used?
Decrease aqueous production:
Beta blocker (Timolol)
Carbonic anhydrase inhibitor (acetazolamide)
M3 agonist (pilocarpine)
Prostaglandin analog (latanoprost)
What is AChE inhibitor's affect on your blood vessel?
None (M3 is not innervated)
When an organ/muscle doesn't respond to indirect agonist but respond to direct agonist, what could be the reason behind that?
Denervation of the organ/muscle
Why ganglionic blocker produce a significant tachycardia with NE?
NE has alpha 1 and beta 1 affect--->reflex bradycardia results from alpha 1 affect--->if block reflex--->unopposed beta 1 results in significant tachycardia
For diuretics, hypokalemia goes with?
Alkalosis (K secretion is coupled with H secretion)
Mannitol is contraindicated in ___ and ___ pt?
CHF and pulmonary edema
How does carbonic anhydrase work?
Na/H antiporter transport H out to the urine--->H combine with HCO3- --->H2CO3---(carbonic anhydrase)--->CO2 and H2O--->CO2 goes into the cell--->combine with H2O---(carbonic anhydrase)--->H2CO3--->H + HCO3- --->HCO3- goes into the blood
What is carbonic anhydrase side effect and what else does it treat besides HTN?
Metabolic acidosis/hyperchloremia (later Cl- reabsorption)/renal stone (due to alkaline urine)
acute mountain sickness
Decrease in bicarb will always accompany with the increase of?
How is Na reabsorbed in the thick ascending limb of the kidney?
Na is absorbed with K+ and Cl- via Na/K/2Cl cotransporter--->create + potential along the luminal membrane--->facilitate Mg and Ca absorption between cells
What are the electrolyte disturbance created by loop diuretics?
They block Na/K/2Cl contrasporter--->hypo Na/K/Cl/Mg/Ca
What are the loop diuretics?
What is loop used for?
Pul edema/HF/hypercalcemia/HTN (thiazide is better)
Which loop does not elicit sulfonamide sensitivity?
Loop with ___ increase risk for ototoxicity?
Which 2 drugs do loop interact with?
Li--->decrease Li clearance
Digoxin--->increase digoxin toxicity from hypokalemia
What are the diuretics that contain sulfonamide?
Carbonic anhydrase inhibitor/loop except for ethacrynic acid/thiazide
Where and how does thiazide diuretics work?
Block Na/Cl cotransporter at early distal tubule
What are some thiazide?
What is thiazide used for mainly?
HTN (#1 choice)/calcium stone/CHF/nephrogenic diabetes insipidus
How does thiazide treat nephrogenic diabetes insipidus?
Use HCTZ--->lose Na--->proximal tubule reabsorb Na to compensate--->water follows--->increase water reabsorption
What are the side effect of thiazide?
Hypokalemia and alkalosis/hypercalcemia/hyperglycemia/hyperglycemia/hyperlipidemia
How does thiazide cause hyperglycemia?
Thiazide--->hypokalemia--->keep K channel open in beta cell of pancreas--->inhibit insulin release--->hyperglycemia
Beta block and thiazide can treat HTN but they both cause?
Which 2 types of diuretics cause hyperuricemia?
Loop and thiazide
What is the most common cause of hypokalemia and metabolic alkalosis?
Loop and thiazide diuretics
Why loop and thiazide cause hypokalemia and alkalosis?
Inhibit Na reabsorption--->kidney try to compensate by reabsorb more Na at principle cell of collecting duct--->Na is reabsorbed and K and H are secreted--->hypokalemia and alkalosis
What is the most common cause of hyperkalemia?
Where else does carbonic anhydrase work besides proximal tubule?
Intercalated cells of collecting duct--->secrete H
What are the 2 kinds of K sparing diuretics?
Na channel blocker--->amiloride/triamterene
Aldosterone receptor blocker--->spironolactone/eplerenone
How does Li cause nephrogenic diabetes insipidus? and what treats it?
Li gets into principle cell of collecting duct--->damage V2 receptor--->don't respond to ADH
Amiloride treats Li induced nephrogenic diabetes insipidus
What pH disturbance do carbonic anhydrase and K sparing agents have?
Difference between spironolactone and eplerenone?
Eplerenone is not antiandrogen