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Flashcards in Diuretics Deck (47)
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1
Q

What do diuretics do?

A

Increase rate of Na excretion and urine outflow

2
Q

Phosphodiesterase inhibitors are derivatives of …

A

Caffeine

3
Q

How do cardiovascular diuretics work?

A

positive inotropes –> increase heart contractility –> increase CO and GFR –> diuretic effect

4
Q

What would you use cardiovascular diuretics to treat?

A

edema associated with CHF

5
Q

What are some examples of cardiovascular diuretics?

A

Digitalis (Digoxin)

Phosphodiesterase inhibitors: Aminophyllin, Inamrinone, Milrinone

6
Q

What are 2 examples of physiological diuretics?

A

water - pee more

NaCl - drink more and therefore pee more

7
Q

Where in the nephron do osmotic diuretics primarily act? Secondarily?

A

primarily: aLOH
secondarily: PCT

8
Q

What is the main osmotic diuretic and how is it administered?

A

Mannitol

IV

9
Q

What would you use Mannitol to treat?

A

Localized edema - cerebral edema, acute glaucoma
Acute renal failure
Poison/toxicity

10
Q

Which drug is used to treat localized edema?

A

Mannitol

11
Q

How do osmotic diuretics act?

A

They pull water towards them into the vasculature, increasing volume in the vasculature and therefore increasing GFR

12
Q

T/F. Mannitol is the diuretic least likely to cause electrolyte imbalance.

A

True

13
Q

How would you administer a loop diuretic?

A

oral or IV

14
Q

T/F. Loop diuretics decrease renal blood flow and GFR.

A

False. Increase RBF and GFR

15
Q

Loop diuretics have a (short/long) duration and a (slow/fast) onset.

A

short duration

fast onset

16
Q

Which is the most common loop diuretic?

A

Furosemide/Lasix

17
Q

What is the method of action of loop diuretics?

A

inhibit the NaK2Cl symporter –> there is electrolyte imbalance and positive charge in the urine –> luminal membrane cells sense this and want to put positive charges in the urine (i.e. - K and H)

18
Q

What is the effect on the body of putting K and H into the urine?

A

Hypokalemia

Systemic alkalosis

19
Q

How does Furosemide trigger the RAAS?

A

by causing a Na deficiency in the blood

20
Q

What is a very important problem in horses that Lasix is used to treat?

A
Exercise-induced pulmonary hemorrhage
Nose bleeds (Epistaxis)
21
Q

What is Furosemide used to treat?

A

Edema of nephrotic syndrome, pulmonary edema/congestion, hypercalcemia (because loops excrete Ca), generalized edema, acute renal failure

22
Q

What is the best drug to use for emergency renal failure?

A

Loop diuretics (because they increase the RBF)

23
Q

Adverse effects of loop diuretics include… (6)

A
  • hypokalemia
  • cardiac arrhythmias
  • systemic alkalosis
  • ototoxicity
  • hypovolemia
  • hypersensitivity
24
Q

Which drug is best to use for enhancing elimination of toxic agents/poisoning?

A

Mannitol

25
Q

What is the only way to administer thiazide diuretics?!

A

per os

26
Q

T/F. Absorption with thiazide diuretics is slow and incomplete.

A

True

27
Q

Do thiazide diuretics increase or decrease BP?

A

decrease

28
Q

T/F. Thiazide diuretics are used to treat renal failure.

A

FALSE. they decrease RBF - don’t use them to treat renal failure

29
Q

Thiazide diuretics are the drug of choice to treat…

A

nephrogenic diabetes insipidus

30
Q

What are 2 examples of thiazide diuretics?

A

hydrochlorothiazide

chlorothiazide

31
Q

Which diuretic can be used to prevent or treat calcium crystals/uroliths?

A

Thiazide diuretics

32
Q

T/F. Thiazide diuretics are weak bases.

A

False. weak acids

33
Q

Which diuretics can cause hyperlipidemia?

A

Thiazide diuretics

34
Q

What are some adverse effects of thiazide diuretics?

A

alkalosis, hypokalemia, electrolyte imbalance

35
Q

T/F. Potassium-sparing diuretics should be given IV.

A

False. per os only!

36
Q

K-sparing diuretics have a (fast/slow) onset and a (long/short) duration.

A

slow onset

long duration

37
Q

Where in the nephron does Spironolactone work?

A

basolateral membrane in the late DCT and CD

38
Q

What would you use Spironolactone to treat?

A
  • hypokalemia (use with another diuretic, the other will be the main diuretic and this will counteract the hypokalemia)
  • hyperaldosteronism (especially during heart failure)
39
Q

How does Spironolactone work regarding aldosterone?

A

competitively blocks aldosterone binding to receptors in the late DCT and CD, therefore decrease aldosterone levels

40
Q

What are some adverse effects of Spironolactone?

A

hyperkalemia, systemic acidosis, reproduction effects with aldosterone

41
Q

How should you administer Triamterene and Amiloride?

A

per os

42
Q

How do Triamterene and Amiloride differ from Spironolactone?

A

They don’t have an effect on aldosterone

They block epithelial sodium channels in the luminal membrane of the DCT and CD

43
Q

Which Carbonic anhydrase inhibitors can be given oral or IV? only oral? ophthalmic?

A

Oral/IV: Acetazolamide
Oral: Methazolamide
Ophthalmic: Dorzolamide, Brinzolamide

44
Q

Why aren’t CA inhibitors used as diuretics?

A

because of their ability to cause systemic acidosis

45
Q

How do CA inhibitors lower IOP?

A

inhibit production of aqueous humor

46
Q

What would you use CA inhibitors to treat?

A

open angle glaucoma

47
Q

Why would you opt to use ophthalmic CA inhibitors to treat open angle glaucoma?

A

to decrease the possibility of systemic acidosis