Diuretics

Question 1

What channels do loop diuretics block

Answer 1

NKCC2 channels in the loop of henle

Question 2

Give an example of a loop diuretic

Answer 2

Fruesmide

Question 3

What affect on calcium do loop diuretics have

Answer 3

Cause hypocalcaemia

Question 4

What are the ADRs for loop diuretics

Answer 4

Ototoxcity, alkalosis, gout, increased LDL

Question 5

What affect on potassium do loop diuretics have

Answer 5

Hypokalaemia as the salt and water not absorbed here is moved to the collecting duct which is absorbed by ENaC which is linked to a ROMK channel so more K is lost

Question 6

What channels do thiazides block

Answer 6

NCCT channels in the DCT

Question 7

What are thiazides used to treat

Answer 7

Hypertension as they are also vasodilators

Question 8

What are the ADRs for thiazides

Answer 8

Gout, hyperglycaemia, increased LDL

Question 9

What do thiazides do to calcium leaves

Answer 9

Gives hypercalcaemia

Question 10

What do thiazides do for potassium levels

Answer 10

Hypokalaemia

Question 11

What channels do amiloride block

Answer 11

ENaC in collecting duct

Question 12

When do you use amiloride

Answer 12

When a patient with hypokalaemia needs a diuretic

Question 13

What does amiloride do to potassium levels

Answer 13

Hyperkalaemia

Question 14

How does spironolactone work

Answer 14

Aldosterone antagonist

Question 15

What does aldosterone do

Answer 15

Inserts more ENaC into the collecting duct - therefore, more salt and water reabsorbed
Speeds up the Na/K/ATPase so more potassium is pumped out of the cells into the blood

Question 16

When is spironolactone used

Answer 16

Heart failure, hypertension and hyperaldosteronism

Question 17

What does spironolactone do to the potassium levels

Answer 17

Hyperkalemia

Question 18

Give an example of an ADH antagonist

Answer 18

Lithium

Question 19

What do ADH antagonists do

Answer 19

Inhibits the actions of ADH so you lose water only

Question 20

True or false; ADH antagonists give diuresis and naturesis

Answer 20

False - only diuresis

Question 21

When do you use ADH antagonists

Answer 21

When the patient is hyponatreamic

Question 22

When are carbonic anhydrase diuretics used

Answer 22

Glaucoma

Question 23

What happens to the acid base balance when using carbonic anhydrase

Answer 23

Lose bicarb giving acidosis

Question 24

What are osmotic agents used for

Answer 24

Swelling in the brain

Question 25

What are some general adverse drug reactions of diuretics

Answer 25

Anaphylaxis, hypovoleamia, hypotension, electrolyte disturbance, metabolic Abnormalities

Question 26

What are the major cause of hyperkalaemia

Answer 26

Reduced urine production | Increased tissue damage

Question 27

What are the effects of hyperkalaemia

Answer 27

Cardiac arrhythmias

Question 28

How do you treat cardiac arrhythmias due to hyperkalameia

Answer 28

1. Calcium gluconate - protect the heart 2. Dextrose/insulin - lowers serum K 2. Calcium resonium - removes K

Question 29

How doe NSAIDs harm the kidneys

Answer 29

Inhibit the production of prostaglandins which cause vasodilation on the afferent arteriole - therefore, if this cant dilate then the GFR will drop further

Question 30

How do ACE inhibitors affect the kidneys

Answer 30

Inhibit vasoconstriction of efferent arteriole so allows a further drop in GFR

Question 31

Give some reasons for diuretic resistance

Answer 31

1. swelling in the gut - cant absorb drugs 2. heart failure - cant pump enough blood to kidneys 3. Liver problems - drugs cant be transported with albumin 4. Kidney problems 5. Salt - lose the effect of the diuretic as the water will follow the salt

Question 32

How does alcohol work as a diuretic

Answer 32

Inhibits ADH release

Question 33

How does caffeine work as a diuretic

Answer 33

Increases GFR and reduces Na reabsorption

Question 34

Which diuretics work in the PCT

Answer 34

Carbonic anhydrase inhibitors | Osmotic diuretics

Question 35

Which diuretics work in the loop of henle

Answer 35

Loop diuretics

Question 36

Which diuretics work in the DCT

Answer 36

Thiazides

Question 37

Which diuretics work in the CD

Answer 37

Spironolactone Amiloride ADH antagonists

Question 38

What diuretics are used for liver disease

Answer 38

Spironolactone | Loop diuretics

Question 39

What diuretics are used for nephrotic syndrome

Answer 39

Loop diuretics in high doses

Question 40

What diuretics are used for oedema

Answer 40

Loop diuretics

Question 41

What diuretics are used in hypertension

Answer 41

1. Thiazide | Possibly spironolactone also

Question 42

What diuretics are used for heart failure

Answer 42

Loop diuretics