Diuretics

Question 1

Carbonic anhydrase inhibitor

Acetazolamide: uses

Answer 1

glaucoma
idiopathic intracranial HTN
altitude sickness
metabolic alkalosis

Question 2

Altitude sickness treatment with acetazolamide

Answer 2

hypoxemia
leading to increased respiratory rate (blowing off CO2)
respiratory alkalosis

metabolic compensation enhanced by acetazolamide which helps you excrete carbonic acid

Question 3

Acetazolamide side effects

Answer 3

metabolic acidosis
hypokalemia
nephrolithiasis

Question 4

Sulfa drugs

Answer 4

acetazolamide
thiazides
loop diuretics

Question 5

What’s the only loop duiretic that is not a sulfa drug?

Answer 5

ethacrynic acid

Question 6

When should you use mannitol, osmotic diuretic?

Answer 6

increased ICP (short term solution)
acute kidney injury
acute angle closure glaucoma

Question 7

Mannitol adverse effects

Answer 7

dilutional hyponatremia initially
osmotic diureses, and relative hypernatremia
hyperosmolarity
pulmonary edema

Monitor serum sodium, serum osmolarity looking for hyperosmolarity

Question 8

Loop diuretics

furosemide
bumetanide
torsemide
ethacrynic acid

Answer 8

CHF
Ascites
Pulmonary edema
Peripheral edema
Hypercalcemia (but be careful with hypercalciuria, in which case loop diuretics might cause more kidney stones)

Question 9

Loop diuretic side effects

Answer 9

ototoxicity
hyperuricemia (don’t give if gout)
hypokalemia (supplement potassium)
hypocalcemia

Question 10

Thiazides

hydrochlorothiazide
metolazone
chlorthalidone

Answer 10

use for 
HTN
early, mild CHF
hypercalciuria
nephrogenic diabetes insipidus

RTA

Question 11

Thiazides- side effects

Answer 11

hypokalemia
hyponatremia
hyperuricemia
hypercalcemia

Question 12

Potassium-sparing diuretics

potassium, “taKe a SEAT”

Answer 12

aldosterone antagonists:
Spironolactone
Epleronone

block sodium channels:
Amiloride
Triamterene

Question 13

Aldosterone antagonists- when do we use them?

Answer 13

Hyperaldosteronism
CHF
Post- MI (especially epleronone)
Portal HTN (especially spironolactone and furosemide)

Question 14

Spironolactone’s anti-androgen effects can be used to treat…

Answer 14

acne

polycystic ovarian syndrome

Question 15

Aldosterone antagonise side efefects

Answer 15

hyperkalemia

gynecomastia, menstrual irregularities (spironolactone)

Question 16

When do we use triamterene and amiloride potassium-sparing diuretics?

Answer 16

HTN
Conserving K+ during diuresis
(combined with HCTZ)
Lithium- induced nephrogenic diabetes insipidus