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Flashcards in Diuretics Deck (11):
1

Carbonic Anhydrase Inhibitors-acetazolamide, methazolamide, dichlorphenamide

-MOAIncreased bicarbonate excretion, urinary alkalinization, Triggers tubuloglomerular feedback (TGF)
leading to decrease in RBF and GFR
-Therapeutic uses - - glaucoma, urinary alkalinization, aid to dissolve renal stones that form in acidic conditions, metabolic alkalosis
-Toxicity - - metabolic acidosis, some renal stone formation (alkaline conditions), hypokalemia, allergic sulfur reactions

2

Osmotic Diuretics-Mannitol, isosorbide, glycerin, urea

-MOA-Limit Na+ and water reabsorption, expand extracellular fluid volume leading to decrease in renin release and increase in RBF
-Increase urinary excretion of nearly all electrolytes including Na+, K+, Ca+2, Mg+2, Cl-, phosphate
-Therapeutic uses - -treatment of acute renal failure, reduction of intracranial and intraocular pressure, treatment of dialysis disequilibrium syndrome
-Toxicity - - expansion of extracellular volume problem with congestive heart failure, pulmonary edema, electrolyte loss

3

Loop Diuretics-Furosemide, bumentanide, ethacrynic acid, torsemide

-MOA-Increase urinary excretion of Na+, Cl-, Ca+2, Mg+2, K+, Block macula densa sensing mechamism and thus block TGF and do not decrease GFR
-Theraputic uses - - pulmonary edema and other edematous states, acute renal failure, hypertension
-Toxicity - - electrolyte loss, ototoxicity, metabolic alkalosis, allergic sulfur reaction (not with ethacrynic acid)

4

Thiazide Diuretics-hydrochlorthiazide, polythiazide, trichlormethiazide, indapamide, chlorthalidone, quinethazone, metolazone, chlorthiazide, methylclothiazide, bendroflumethiazide, hydroflumethiazide

-MOA-Increase urinary excretion of Na+, Cl-, K+
Decrease urinary excretion of Ca+2, No effects on TGF or RBF
-Therapeutic uses - - hypertension, edema, calcium nephrolithiasis
-Toxicity - - hyponatremia, hypokalemia, metabolic alkalosis, hypercalcemia, allergic sulfur reaction

5

K+ Sparing Diuretics-triamterene, amiloride, spironolactone, eplerenone

-MOA-Increase urinary excretion of Na+, Decrease urinary excretion of K+, H+, Do not effect TGF or RBF
-Triamterene and amiloride are ENaC inhibitors
-Eplerenone and spironolactone are aldosterone antagonists
-Therapeutic uses - - in combination with other diuretics to treat: hypertension, edema
-for spironolactone and eplerenone-hyperaldosteronism, endocrine diseases
Toxicity - - hyperkalemia, metabolic acidosis, gynecomastia, impotence (spironolactone)

6

Neseritide

-Brain natriuretic peptide
-MOA-binds to specific receptors and via c-GMP signaling inhibits Na+ reabsorption in the inner medullary collecting duct and thus increase Na+ excretion, also inhibits renin-Ang II-aldosterone pathway
-given IV
-currently limited therapeutic use acutely decompensated CHF

7

What are the Carbonic anhydrase inhibitors (3)

acetazolamide, methazolamide, dichlorphenamide

8

What are the osmotic diuretics (4)

Mannitol, isosorbide, glycerin, urea

9

What are the loop diuretics (4)

Furosemide, bumentanide, ethacrynic acid, torsemide

10

What are the thiazide diuretics (11)

hydrochlorthiazide, polythiazide, trichlormethiazide, indapamide, chlorthalidone, quinethazone, metolazone, chlorthiazide, methylclothiazide, bendroflumethiazide, hydroflumethiazide

11

What are the K+ sparring diuretics (4)

triamterene, amiloride, spironolactone, eplerenone