Diuretics Flashcards

1
Q

how are diuretics classified?

A

Site of action

mechanism of action

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2
Q

What are the types of diuretics?

A
Thiazides
Loop
Osmotic
Aldosterone Antagonists
Carbonic Anhydrase Inhibitors
K+ Sparing
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3
Q

What is the mechanism of action and site of action of thiazide diuretics?

A
Mechanism of Action
Inhibit Na and Cl reabsorbtion
Site of Action	Ascending loops of Henle
What really happens?
↑ excretion of ions
↓ K+ 
↓ extracellular fluid volume
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4
Q

What are the clinical uses of thiazides?

A

Essential HTN (alone or in combo)
Edema
Diabetes Insipidus**
Hypercalcemia
**

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5
Q

how do thiazides exert their antihypertensive effect?

A

Initially, ↓ extracellular fluid volume
↓ cardiac output
Long term, peripheral vasodilation

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6
Q

What are the side effects of thiazides?

A
HYPOKALEMIC, HYPOCHLOREMIC METABOLIC ALKALOSIS
Cardiac Dysrhythmias
Hypokalemia
Hypovolemia
Orthostatic hypotension
Hyperglycemia
Hyperuricemia
Renal/hepatic failure
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7
Q

What are 2 examples of loop diuretics?

A

Ethacrynic acid

Furosemide

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8
Q

How do loop diuretics work?

A

Inhibit ion reabsorption in the medullary portion of ascending limbs of loop of Henle

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9
Q

What are clinical uses of loop diuretics?

A

Mobilization of edema

Treatment of ICP

Differential diagnosis of oliguria
-pt must be normal volemic and good kidneys before you give it
NOT treatment for essential HTN

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10
Q

What are the side effects of loop diuretics?

A
Fluid and electrolyte imbalance
-Hypokalemic metabolic alkalosis
Hypokalemia
↑ Digitalis toxicity
Potentiate NMB drugs
Hyperuricemia
Aminoglycoside toxicity
Sulfonamide allergy
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11
Q

What are some characteristics and MOA of osmotic diuretics?

A
Freely filterable at the glomerulus
Undergo limited reabsorption
Resist metabolism
Pharmacologically inert
Mechanism of Action
↑ osmolarity of renal tubular fluid and prevents reabsorption of water
↑ plasma osmolarity
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12
Q

What are clinical uses for osmotic diuretics?

A

Prophylaxis against renal failure
-before cross clamp if clamped above renal artery
Differential Diagnosis of oliguria

Treatment of Increased ICP

Reduction of Intraocular pressure

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13
Q

What are the side effects of osmotic diuretics?

A

Pulmonary edema
Hypovolemia
Electrolyte imbalanc
Plasma hyperosmolarity

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14
Q

What is the dose for mannitol?

A

0.25-1 g/kg

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15
Q

What are examples of K sparing diuretics?

A

Tiamterene

Amiloride

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16
Q

Where do k sparing diuretics work?

A

convoluted tubules

17
Q

What are the clinical uses of K sparing diuretics?

A

used in place of or in combo with other diuretics

18
Q

What is the side effect of K sparing diuretics?

A

hyperkalemia

19
Q

What is an example of an aldosterone agonist?

A

spironolactone

20
Q

What is the use of aldosterone antagonists?

A

usually only hepatic failure/ascites

21
Q

What is an example of carbonic anhydrase inhibitor? What does it do?

A

acetazolamide

inhibits CA in proximal tubules/inhibits naHCO3 reabsorbtion

22
Q

What are the clinical uses of carbonic anhydrase inhibitors?

A

Eye surgery-decrease production of vitreous humor-> decrease IOP

23
Q

What is the onset time and dose of Lasix?

A

Onset: 2-10 min
Dose: 0.1 - 1 mg/kg

24
Q

How much Lasix is needed to increase urine output?

A

Only 10 mg or 1cc

25
Q

What is usually given to treat hyperkalemia during liver transplant?

A

Lasix

26
Q

What diuretic is not good for heart failure patients?

A

Mannitol since it acutely increases intravascular volume

27
Q

What electrolyte imbalances do osmotic diuretics cause?

A

Hyperkalemia
Hypernatremia

Think of “free water”

28
Q

Lasix is associated with ________ alllergy

A

sulfa