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Diuretics Flashcards

1
Q

PCT absorption

A

60-70% total reabsorption of Na

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2
Q

Major site for sodium bicarbonate and NaCl reabsorption

AA, glucose, cations, uric acid

A

PCT

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3
Q

Site of SGLT2 inhibitors

A

PCT

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4
Q

4 pumps in PCT

A

1 Na HCO3
2 Na/K ATPase
3 Cl pump (in)
4 Na-Glucose (SGLT2) Co transporter

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5
Q

Inhibits carbonic anhydrase
Promotes NaHCO3 depletion
Enhances NaCl absorption
Dec diuretic effect after several days (water retention)

Examples

A 
Acetazolamide
Methazolamide
Dichlorphenamine
Dorzolamine
Brinzolamine
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6
Q

Well absorbed after oral admin
Inc in urine pH in 30 mins
Dose reduced renal insufficiency

A

Carbonic anhydrase

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7
Q

CA for glaucoma

A

Acetazolamide

Brinzolamide

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8
Q 
For glaucoma
Urinary alkalinization
Metabolic alkalosis
Acute mountain sickness
Sleep apnea
A

CA inhibitors

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9
Q

CA inhibitor toxicity

A 
Hyperchloremic metabolic acidosis
Renal stones
K wasting
Drowsiness
Hypersensitivity
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10
Q

CA I CI in

A

Cirrhosis

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11
Q

Carbonic anhydrase inhibitors act on

A

PCT

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12
Q

Inhibits SGLT2 transporter at PCT
Rapidly absorbed from GIT
Inhibits reabsorption of sugar so they are exrected in urine

A

DapaglifloZin
CanaglifloZin
EmpaglifloZin

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13
Q

SGLT2 flozin CI

A

Severe renal and liver disease

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14
Q

Reduces total exposure of dapaglifloZin by 22%

A

Rifampin

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15
Q

SGLT2 indication

A

DM
dec HbA1C (0.5-1%)
weight loss
drop in systolic BP

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16
Q

SGLT2 toxicity

A

Genital funga infection in women
Hypoglycemia
UTI

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17
Q

Reabsorption of Na (25%), K and Cl via NK2Cl carrier takes place in the

A

Loop of Henle

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18
Q

Major site of Mg and Ca reabsorption

A

LOH

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19
Q

Impermeable to water

A

Thick ascending limb LOH

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20
Q

Transportes in TAL LOH (4)

A

1 NaK2Cl Co transporter
2 Na/K ATPase
3 K/Cl- Co transporter
4 K, Mg, Ca

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21
Q

Inhibits NK2Cl Co transporter

Short acting

A 
Loop diuretics
Furosemide
Bumetanide
Torsemide
Ethacrynic acid
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22
Q

Causes massive NaCl diuresis, K sexcretion at collecting duct

Significant dec in BP

Loss of lumen positive potential

Reduced pulmonary vasculature

A

Loop diuretics

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23
Q

Tx of edematous states in HF, ascites, acute pulmonary edema

Hypertension if TZD inadequate

Severe hypercalcemia

A

Loop diuretics

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24
Q

Loop diuretic SE (4)

A

Hypovolemia
Ototoxicity
Sulfonamide allergy
Hypokalemic metabolic alkalosis

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25
Site of 10% NaCl reabsorption via NaCl Co-transporter (NaCC) Impermeable to water (more dilute tubular fluid) Ca reabsorption regulated by PTH
Distal convolutee tubule
26
DCT transporters (5)
``` 1 Na/K ATPase 2 Na-Cl Co transporter 3 Ca pump 4 Na-Ca exchanger 5 Ca-H ATPase ```
27
Drugs that act on DCT
Thiazide diuretics HCZ Chlorothiazide IV Chlorthalidone
28
Inhibits NCC in early DCT DOA: 6-12h Oral route Synergistic with loop diuretics
Thiazide
29
Moderate but sustained NaCl diuresis Promotes Na-Ca exchange at basolateral membrane (inc Ca reabsorption) For Nephrogenic Diabetes inspidus
Thiazide diuretics
30
Thiazide diuretics SE (7)
``` Massive sodium diuresis Hypokalemic metabolic alkalosis Hyperglycemia Hyperuricemia Hyperlipidemia Sulfonamide allergy Hypotension ```
31
Site of reabsorption for 2-5% of NaCl final site | Site of action of aldosterone
Collecting tubule and duct
32
Site of potassium secretion and urinary acidification
CD and duct
33
Principal cells of CD transport
Na, K, Water
34
Intercalated cells of CD facilitate secretion of
H (alpha) | HCO3 (beta)
35
Transporter in CD Principal Cell (3)
Na/K ATPase ENaC K out
36
Transporter at CD Intercalated Cell (2)
1 HCO3-Cl exchanger | 2 H ATPase pump
37
Aldosterone act on the
Principal cells of CD
38
Site of final urine concentration
Collecting tubules and collecting duct
39
Regulates insertion of pre formed water channel aquaporin 2 on apical membrane
ADH | Vasopressin
40
Loss of ADH in apical membrane of CT makes it
impermeable to water | Dilute urine
41
ADH also stimulates insertion of
Urea transporter in apical mem
42
Drugs that act on CD
K sparing diuretics
43
Blocks intracellular aldosterone receptor
Spironolactone | Eplerenone
44
Blocks ENaC
Triamterene | Amiloride
45
Inc sodium clearance | Dec potassium and hydrogen excretion
K sparing diuretic
46
To counteract K wasting due to thiazide or loop use (Hypokalemia) Hyperaldosteronism Heart failure
K Sparing diuretic
47
K Sparing diuretic SE
Hyperkalemic metabolic acidosis
48
Spironolactone may cause
gynecomastia
49
K sparing diuretics should not be given with
ACE and ARB
50
activates V2 receptor causing insertion of aquaporin 2 channels in apical membrane
ADH agonist | Desmopressin
51
Desmopressin causes (2)
Dec urine volume | Inc urine conc
52
Desmopressin if for
Diabetes insipidus neurogenic
53
Desmopressin may cause (2)
Dilutional hyponatremia | Hypertension
54
Blocks V1 and V2 receptor
ADH antagonist Conivaptan Demeclocyline Lithium
55
Selective V2 blocker inhibiting ADH
Tolvaptan
56
Conivaptan and Tolvaptan promotes (2)
Inc urine volume | Dec urine conc
57
Tonivaptan | Conivaptan indicated for
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Heart failure
58
ADH antagonists SE
Demyelination if with hyponatremia rapid correction
59
Demeclocyline SE
Bone and teeth abnormality
60
Lithium SE
Nephrogenic DI
61
Conivaptan SE
Infusion site reaction
62
Freely filtered at glomerulus but poorly reabsorbed from tubule
``` Osmotic diuretics Mannitol Glycerin Urea Isosorbide ```
63
Osmotic diuretics act at the
PCT
64
Osmotic diuretics cause (3)
Inc urine volume Inc excretion of solute Dec brain volume and ICP, IOP
65
Maintains high urine flow (severe hemolysis, rhabdomyolysis, TLS) Acute glaucoma Dec ICP in neuro condition
Osmotic diuretic
66
Osmotic diuretic SE (5)
``` Hypernatremia Hypovolemia Pulmonary edema Headache N&V ```

Pharma (26 decks)

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