Diuretics and Aquaretics - Bahouth Flashcards Preview

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Flashcards in Diuretics and Aquaretics - Bahouth Deck (26):
1

What is the mechanism of action of acetazolamide?

Potent competitive inhibitor of carbonic anhydrase

2

Where does acetazolamide act?

Proximal tubule (90%)

Distal tubule (10%)

3

What is the net effect of acetazolamide?

Alkaline urine

Increased chloride reabsorption (hyperchloremic systemic acidosis)

4

What are the clinical uses of carbonic anhydrase inhibitors?

Glaucoma

Cystinuria

Seizures

Mountain sickness

5

What is the mechanism of action of mannitol?

Osmotically inhibit Na / H20 reabsorption in PCT

Increase ECFV / renal medullary blood flow

Decrease medullary tonicity

6

What are the clinical uses of osmotic diuretics?

Treatment of dialysis disequilibrium syndrome

Reduce intracranial pressure

Reduce intraocular pressure

7

What are examples of loop diuretics?

Furosemide

Bumetanide

Torsemide

8

What is the mechanism of action of loop diuretics?

Inhibit Na-K-2Cl symporter in TALH

Increase renal blood flow

Increaes renal prostaglanins

Stimulate renin release and maintain GFR

9

What are the net effects of loop diuretics?

NaCl loss

Diuresis

Increase K, H, Ca, and Mg excretion

Impair ability to concentrate urine

10

What are the clinical uses of loop diuretics?

Edema

11

What are significant features of furosemide?

Safe

Dilates veins

Hyperglycemia

Hyperurecemia

12

What are significant features of bumetanide?

Useful with warfarin

13

What are significant features of torsemide?

Vasodilator

14

What are examples of thiazide diuretics and which are most potent?

Most potent - Metolazone, Quinothazone

Hydrochlorothiazide

Chlorthalidone

15

What is the mechanism of action of thiazide diuretics?

Inhibit NaCl symporter in early distal tubule

16

What are the net effects of thiazide diuretics?

Loss of Na and water

Increased K excretion

17

What are the clinical uses of osmotic diuretics?

Edema

Essential hypertension

Diabetes insipidus

Hypercalciurea

18

What are side effecs of Thiazide diuretics?

hypokalemia / hypomagnesemia

hyperuricemia / hypercalcemia / hyperglycemia

lipid disorders

19

What is the mechanism of action of spironolactone?

Competitive inhibitor to aldosterone in late DCT and CD.

20

What is the mechanism of action of eplenorone?

Competitive inhibitor to aldosterone in late DCT and CD.

21

What are the net effects of aldosterone antagonists?

Increase sodium excretion

Reduce potassium secretion

22

What are side effects of spironolactone?

Gynecomastia (males)

Hirsutism and uterine bleeding (females)

23

What is the mechanism of action of triamterene?

Inhibits Na reabsorption and K secretion DCT and CD

24

What is the mechanism of action of amiloride?

Inhibits Na reabsorption and K secretion DCT and CD

25

What are effects of ADH?

Increase water permeability in CD (V2)

Vasopressor (V1)

26

What are the clinical uses of ADH-like drugs?

ADH-sensitive diabetes insipidus

Nephrogenic diabetes insipidus