Diuretics

Question 1

What are the classes of drugs that act on the renal tubule?

Answer 1

Carbonic anhydrase inhibitors
Osmotic diuretics 
Loop diuretics 
Thiazides
Potassium sparing diuretics
Aldosterone antagonists
ADH antagonists

Question 2

Where do carbonic anhydrase inhibitors act?

Answer 2

PCT

Question 3

Where do osmotic diuretics act?

Answer 3

PCT
Descending limb of LOH
CD

Question 4

Where do Loop diuretics act?

Answer 4

Thick ascending limb of LOH

Question 5

Where do thiazides act?

Answer 5

DCT

Question 6

Where do potassium sparing diuretics act?

Answer 6

CD

Question 7

Where do aldosterone antagonists act?

Answer 7

CD

Question 8

Where do ADH antagonists act?

Answer 8

CD

Question 9

What are examples of osmotic diuretics?

Answer 9

Mannitol

Question 10

What is the mechanism of mannitol?

Answer 10

Increases osmolarity of filtrate so water follows

Question 11

What are the routes of administration for mannitol?

Answer 11

IV

Question 12

What are the indications for mannitol?

Answer 12

Cerebral oedema

Raised ICP

Question 13

What are the side effects of mannitol?

Answer 13

Cough
Headache
Vomiting

Question 14

What are examples of carbonic anhydrase inhibitors?

Answer 14

Acetazolamide
Brinzolamide
Dorzolamide

Question 15

What are the indications for carbonic anhydrase inhibitors?

Answer 15

Glaucoma

Altitude sickness

Question 16

What are the routes of administration for carbonic anhydrase inhibitors?

Answer 16

PO

IV

Question 17

What is the mechanism of carbonic anhydrase inhibitors?

Answer 17

Inhibits carbonic anhydrase
Reduces formation of hydrogen and bicarbonate ions from CO2
Promotes renal excretion of Na, K, HCO3, H2O

Question 18

What are the side effects of carbonic anhydrase inhibitors?

Answer 18

Acidosis

Renal stones

Question 19

What are examples of loop diuretics?

Answer 19

Furosemide

Bumetanide

Question 20

What are indications for loop diuretics?

Answer 20

Oedema
Heart failure
Hypertension

Question 21

What is the mechanism of loop diuretics?

Answer 21

Inhibit Na/K/2Cl cotransporter in the loop of Henle

Na remains in tubule and water follows

Question 22

What are the side effects of loop diuretics?

Answer 22

Myalgia 
Thirst
Weight loss
Headaches 
Alkalosis

Question 23

What is an example of a thiazide diuretic?

Answer 23

Bendroflumethiazide

Question 24

What is an example of a thiazide like diuretic?

Answer 24

Indapamide

Question 25

What is the indication for Bendroflumethiazide?

Answer 25

Hypertension

Question 26

What is the route of administration for Bendroflumethiazide?

Answer 26

Oral

Question 27

What is the mechanism of action of Bendroflumethiazide?

Answer 27

Inhibits Na reabsorption in DCT

Question 28

What are side effects of Bendroflumethiazide?

Answer 28

``` Hypokalaemia Increased urea Impaired glucose tolerance Nausea Dizziness ```

Question 29

What is the indication for indapamide?

Answer 29

Hypertension

Question 30

What are the routes of administration of indapamide?

Answer 30

PO

Question 31

What is the mechanism of action of indapamide?

Answer 31

Inhibits Na reabsorption in DCT

Question 32

What are the side effects of indapamide?

Answer 32

``` Hypokalaemia Increased urea Impaired glucose tolerance Nausea Dizziness Mild rash ```

Question 33

What is an example of a potassium sparing diuretic?

Answer 33

Amiloride

Question 34

What is the indication for amiloride?

Answer 34

Oedema Hypertension Heart failure With low potassium

Question 35

What are the routes of administration for amiloride?

Answer 35

Oral

Question 36

What is the mechanism of amiloride?

Answer 36

Blocks ENaC at luminal surface of renal tubule

Question 37

What are side effects of amiloride?

Answer 37

``` Hyperkalaemia Constipation Dizziness Dry mouth D+V ```

Question 38

What is an example of an aldosterone antagonist?

Answer 38

Spironolactone

Question 39

What are the indications for spironolactone?

Answer 39

``` Oedema Ascites Hypertension Heart failure Nephrotic syndrome ```

Question 40

What is the mechanism of spironolactone?

Answer 40

Competes with aldosterone at mineralocorticoid receptor Prevents upregulation of ENaC

Question 41

What are the side effects of spironolactone?

Answer 41

Hyperkalaemia Impotence Painful gynaecomastia Refractory hyperaldosteronism

Question 42

What is an example of an ADH antagonist?

Answer 42

Tolvaptan

Question 43

What is the route of administration of tolvaptan?

Answer 43

Oral

Question 44

What are the indications for tolvaptan?

Answer 44

Hyponatraemia | PCKD

Question 45

What is the mechanism of tolvaptan?

Answer 45

Blocks AHD at receptor so inhbits aquaporin expression Reduces free water reabsorption so increases plasma sodium concentration

Question 46

What are the side effects of tolvaptan?

Answer 46

``` Hypernatraemia Deranged liver function Dry mouth Constipation Dehydration ```