Diuretucs

Question 1

What is the first line therapy of HF

Answer 1

Diuretics

Question 2

What are the effects of all diuretics

Answer 2

Decrease plasma volume and cardiac output, increase HR, increase plasma renin, increase SNS

Question 3

What are the thiazide diuretics names?

Answer 3

Metazalone, chlorthalidone, indapamide, HCTZ, chlorothiazide

Question 4

What are the loop diuretics?

Answer 4

Furosemide, bumetanide, torsemide

Question 5

What are the potassium sparing diuretics?

Answer 5

Amiloride, spironolactone, triamterene

Question 6

Where do TZDs work

Answer 6

Distal consulates tubule

Question 7

Where do loop diuretics work

Answer 7

Ascending loop of henle

Question 8

Where do potassium sparing work

Answer 8

Late distal tubule and collecting duct

Question 9

What are the carbonic anhydrase diuretics work

Answer 9

Proximal tubule

Question 10

What are the carbonic anhydrase diuretics

Answer 10

Acetazolamide, methazolamide

Question 11

What are the most common osmotic diuretics

Answer 11

Mannitol

Question 12

What can mannitol treat?

Answer 12

Increased ICF

Question 13

How much mmhg do TZDs lower BP by

Answer 13

10-15

Question 14

When are TZDs not effective

Answer 14

In creatinine clearance less than 30

Question 15

Which TZD is often used for benign essential HTN

Answer 15

HCTZ

Question 16

How do TZDs work

Answer 16

They decrease plasma volume by increasing sodium and water excretion in distal tubules.

They also reduce contraction of the arterial smooth muscle cells causing a reduction in response to vasopressors like norepinephrine and angiotensin

Question 17

What is the adverse effects of TZDs

Answer 17

Increase in LDL and triglycerides and impaired carbs tolerance in patients with type 2 DM

Lowers electrolytes of potassium, sodium, and magnesium
Raises uric acid, calcium, sugar, and hyperlipidemia

Question 18

Which diuretics can patients with a sulfa allergy not take?

Answer 18

TZDs and Loop and carbonic anyhdrase inhibitors

Question 19

What effect do TZDs have with loop diuretics?

Answer 19

They lower the dose needed of loop

Question 20

When edema is present which diuretic is indicated?

Answer 20

Aldosterone receptor antagonists

Question 21

Which patients should use caution with TZDs

Answer 21

Renal function, electrolyte abnormalities, volume depletion, elderly, seizures, diabetes, gout, and pancreatitis

Question 22

What does TZDs do to uric acid

Answer 22

They increase the excretion of uric acid

Question 23

When are TZDs contraindicated in pregnancy

Answer 23

During the last trimester, and people with reduced placental perfusion like pre eclampsia or intrauterine growth retardation

Question 24

What are the best diuretics to use in patients with poor renal function

Answer 24

Loop

Question 25

How do loop diuretics work

Answer 25

Inhibit sodium potassium chloride pump in the ascending loop of henle

Question 26

What do loop diuretics decrease

Answer 26

HCO3 and urate excretion, calcium and magnesium , potassium, sodium, and chloride

Question 27

When are loop diuretics most commonly used

Answer 27

Pulmonary edema, hyperkalemia, chronic HF, HTN, and emergent hypercalcemia

Question 28

What are the AEs of loop diuretics

Answer 28

Low electrolytes, metabolic alkalosis, ototoxicity, hypovolemia, gout

Question 29

When are loop contraindicated

Answer 29

Sulfa allergy, Anuria, hepatic coma, severe electrolyte depletion

Question 30

Which loop causes the worst ototoxicity

Answer 30

Ethycrinic acid

Question 31

What effects and reduces all Diuretics

Answer 31

NSAIDs

Question 32

What are the aldasetrone antagonists/ potassium sparing diuretics

Answer 32

Spironolactone, eplerenone, triathlete, amiloride

Question 33

Where do potassium sparing diuretics work

Answer 33

Collecting tubule

Question 34

How do potassium sparing work

Answer 34

They compete with aldosterone receptors and reduce sodium absorption and secretion of potassium

Question 35

How is eplerenone different than spironolactone

Answer 35

It does not have the adverse effects of gynocomastia and impotence. It’s used with ACE or ARB in HF

Question 36

How does amiloride differ from other potassium sparing

Answer 36

More potent and less toxic

Question 37

Patients with a hypersensitivity to anuria should avoid what class of diuretics

Answer 37

Potassium sparing

Question 38

How does the carbonic anhydrase inhibitor acetazolamide work

Answer 38

Acts at the proximal tubule and secondarily at the collecting duct

Question 39

Which diuretic is also used as a sulfonamide antibiotic

Answer 39

Carbonic anhydrase inhibitor acetazoamide

Question 40

When is acetazolamide used other than diuresis

Answer 40

Glaucoma, metabolic acidosis. Elevation sickness, and adjuvant in seizure disorders

Question 41

When is acetazolamide contraindicated

Answer 41

Hepatic cirrhosis and sulfa allergy

Question 42

What can mannitol be used for

Answer 42

Oliguria, elevated intraoccular pressure, elevated ICF, peripheral edema, forced diuresis

Question 43

How do osmotic diuretics work

Answer 43

Elevate GFR and increase urinary output

Question 44

When are osmotic diuretics contraindicated

Answer 44

Renal disease, dehydration, active intracranial bleeding, pulmonary edema

Question 45

What a diuretic class acts on the thick, ascending limb

Answer 45

Loop

Question 46

Which direct class acts on the distal ambulated tubule

Answer 46

TZD

Question 47

What diuertic class acts on the cortical collecting tube?

Answer 47

Potassium sparing

Question 48

At what site do carbonic anhydrase inhibitors act

Answer 48

Proximal convoluted tubule

Question 49

Which class of diuretics are the most effective?

Answer 49

Loop diuretics, but they also caused the most electrolyte imbalances

Question 50

What diuretic should you monitor blood sugar with regularly?

Answer 50

TZD