Diuretics

Question 1

Carbonic Anhydrase Inhibitors

Answer 1

Azetazolamide

Dorzolamide

Question 2

MOA CAI

Answer 2

inhibit CA 4 on PCT brush border and CA 2 in cytoplasm

Results in decreased IC H generation for Na-counter transport = decreased Na/HCO3 reabsorption

Question 3

CAI TX

Answer 3

glaucoma
altitude sickness
induce urinary alkalinization
edema (in combo w/NKCC/NCC)

Question 4

CAI AE

Answer 4

bicarbonaturia
hyperchloremic metabolic acidosis
hypo-K
paresthesia
renal stone

Question 5

Contraindication CAI

Answer 5

cirrhosis - high plasma NH4

Question 6

Osmotic Diuretics

Answer 6

Mannitol
Glycerin
Isosorbide
Urea

Question 7

MOA Osmotic diuretics

Answer 7

increase tubular fluid osmotic pressure = decreased tubular fluid reabsorption in PT, thin limbs of LH main)
Increased distal flow = increased K secretion

Question 8

Osmotic Diuretics TX

Answer 8

decrease intracerebral pressure in cerebral edema
Oliguric state in prophylaxis of acute RF - expand ECV, maintain GFR, increase flow
Decrease intraorbital pressure in glaucoma

Question 9

AE Osmotic diuretics

Answer 9

pulmonary edema in pts w/HF
Hyponatremia
Hypovolemia

Question 10

Contraindication Osmotic diuretics

Answer 10

anuria (renal disease)
Impaired liver function (urea)
active cranial bleeds (mannitol/urea)

Question 11

NKCCi inhibitors

Answer 11

Loop diuretics
Furosemide
Ethacrynic acid

Question 12

MOA NKCCi

Answer 12

inhibit Na-K-2Cl cotransporter = reabsorption of solute from thick ascending LH
Venodilation - decrease RA pressure and pulmonary cap wedge pressure (minutes)
Increase Ca/Mg excretion by decreasing potential/transport

Question 13

NKCCi TX

Answer 13

acute PE
CHF
HTN
Refractory edema
acute renal failure
anion OD
hypercalemia

Question 14

NKCCi AE

Answer 14

sulfonamide HSN - furosemide
hypokalemia 
alkalosis
hypocalemia
hypomagnesia
ototoxic 
hyperuricemia (ethacrynic acid)

Question 15

NCCi

Answer 15

thiazides/sulfonamides
Chlorthalidone
Hydrochlorthalidone
Indapamide

Question 16

MOA NCCi

Answer 16

inhibit DCT Na-Cl cotransporter = block Na/Cl reabsorption

Increased luminal Na/Cl in DCT, diuresis, low Ca excretion, venorelaxation

Question 17

TX NCCi

Answer 17

systemic arterial HTN (effective)
CHF - edema
Nephrolithiasis
NDI

Question 18

AE NCCi

Answer 18

sulfonamide HSN
hypokalemia
hypercalcemia
hyperuricemia 
hyperglycemia
hyperlipidemia

Question 19

Interactions with NCCi

Answer 19

digoxin (hypokalemia)

avoid in pts w/DM

Question 20

Renal Epithelial Na Channel inhibitors

Answer 20

Amilordine

Triamterene

Question 21

MOA renal epithelial Na channel inhibitors

Answer 21

block DCT/CT/CCD Na channels

Modest natriuresis and prevention of K loss

Question 22

TX renal epithelial Na channel inhibitors

Answer 22

hypokalemic alkalosis in combination with loop diuretics and thiazides

Question 23

Aldosterone receptor antagonists

Answer 23

Spironoloactone

Eplerenone

Question 24

MOA Aldosterone receptor antagonists

Answer 24

antagonize in CT
Decrease Na reabsorption
Decrease loss of K in exchange for Na

Question 25

TX Aldosterone receptor antagonist

Answer 25

``` prevention of LV remodeling and cardiac fibrosis prevent sudden cardiac death hemodynamic reduction vascular effects hyperaldosteronism adjunct to K-wasting diuretics refractory edema ```

Question 26

AE Aldosterone receptor antagonist

Answer 26

hyperkalemia metabolic acidosis binds other steroid receptors