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Flashcards in Diuretics Deck (36)
1

What drugs are used to treat acute closed angle glaucoma?

Carbonic anhydrase inhibitor and beta blocker

2

Which 2 group of drugs should not be used with pt with closed angle glaucoma?

Anti M and alpha 1 agonist

3

What are the 2 ways of treating glaucoma and what drugs are used?

Decrease aqueous production:
Beta blocker (Timolol)
Carbonic anhydrase inhibitor (acetazolamide)
Increase drainage:
M3 agonist (pilocarpine)
Prostaglandin analog (latanoprost)
Mannitol

4

What is AChE inhibitor's affect on your blood vessel?

None (M3 is not innervated)

5

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

6

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

7

For diuretics, hypokalemia goes with?

Alkalosis (K secretion is coupled with H secretion)

8

Mannitol is contraindicated in ___ and ___ pt?

CHF and pulmonary edema

9

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

10

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

11

Decrease in bicarb will always accompany with the increase of?

Cl-

12

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

13

What are the electrolyte disturbance created by loop diuretics?

They block Na/K/2Cl contrasporter--->hypo Na/K/Cl/Mg/Ca
Alkalosis
Ototoxicity

14

What are the loop diuretics?

Furosemide/torsemide/ethacrynic acid

15

What is loop used for?

Pul edema/HF/hypercalcemia/HTN (thiazide is better)

16

Which loop does not elicit sulfonamide sensitivity?

Ethacrynic acid

17

Loop with ___ increase risk for ototoxicity?

Aminoglycoside

18

Which 2 drugs do loop interact with?

Li--->decrease Li clearance
Digoxin--->increase digoxin toxicity from hypokalemia

19

What are the diuretics that contain sulfonamide?

Carbonic anhydrase inhibitor/loop except for ethacrynic acid/thiazide

20

Where and how does thiazide diuretics work?

Block Na/Cl cotransporter at early distal tubule

21

What are some thiazide?

HCTZ (hydrochlorothiazide)/chlorthalidone/indapamide

22

What is thiazide used for mainly?

HTN (#1 choice)/calcium stone/CHF/nephrogenic diabetes insipidus

23

How does thiazide treat nephrogenic diabetes insipidus?

Use HCTZ--->lose Na--->proximal tubule reabsorb Na to compensate--->water follows--->increase water reabsorption

24

What are the side effect of thiazide?

Hypokalemia and alkalosis/hypercalcemia/hyperglycemia/hyperglycemia/hyperlipidemia

25

How does thiazide cause hyperglycemia?

Thiazide--->hypokalemia--->keep K channel open in beta cell of pancreas--->inhibit insulin release--->hyperglycemia

26

Beta block and thiazide can treat HTN but they both cause?

Hyperlipidemia

27

Which 2 types of diuretics cause hyperuricemia?

Loop and thiazide

28

What is the most common cause of hypokalemia and metabolic alkalosis?

Loop and thiazide diuretics

29

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

30

What is the most common cause of hyperkalemia?

Renal failure

31

Where else does carbonic anhydrase work besides proximal tubule?

Intercalated cells of collecting duct--->secrete H

32

What are the 2 kinds of K sparing diuretics?

Na channel blocker--->amiloride/triamterene
Aldosterone receptor blocker--->spironolactone/eplerenone

33

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

34

What pH disturbance do carbonic anhydrase and K sparing agents have?

Metabolic acidosis

35

Difference between spironolactone and eplerenone?

Eplerenone is not antiandrogen

36

Paring with what HTN drugs with K sparing diuretics might cause hyperkalemia?

ACEI or ARB