Lecture 1 Flashcards
(28 cards)
Carbonic Anhydrase Inhibitors
Acetazolamide and Dorzolamide
sulfonamide derivatives
proximal tubule
Osmotic diuretics
mannitol
loop diuretics
furosemide, bumetanide and torsemide
sulfonamide derivatives
Highly efficacious:
- Rapid onset
- Short duration
Thiazide diuretics
hydrochlorothiazide and chlorthalidone
contain a sulfonamide group
potassium sparing diuretics: renal sodium channel inhibitors
triamterene
potassium sparing diuretics: aldosterone antagonists
spironolactone and eplerenone
anti-diuretics
desmopressin acetate
carbonic anhydrase inhibitor therapeutic uses
not very effective diuretics
glaucoma
acute mountain sickness
epilepsy
metabolic alkalosis
carbonic anhydrase inhibitor adverse effects
hyperchloremic metabolic acidosis
urinary alkalization
hypokalemia
sulfonamide allergic hypersensitivity (Stevens-Johnson Syndrome)
ocular adverse effects
osmotic diuretic mechanism of action
Remains in extracellular compartment: can extract water from peripheral intracellular stores
Filtered by the glomeruli: Increases osmotic pressure inside the lumen of the nephron
osmotic diuretic therapeutic uses
Reduction of intraocular pressure
Reduction of intracranial pressure or cerebral edema
osmotic diuretic adverse effects
Pulmonary congestion - could lead to pulmonary edema in patients with heart
failure
loop diuretic mechanism of action
Blocks the Na+-K+-2Cl symporter in the thick
ascending limb of the Loop
of Henle
loop diuretic therapeutic uses
Acute pulmonary edema
Chronic CHF
Ascites due to cirrhosis
Hypertension
Edema
Hypercalcemia
loop diuretic adverse effects
Profound electrolyte and fluid loss: hyponatremia, hypovolemia and hypotension
Hypokalemia
Gout
Ototoxicity
Sulfonamide allergic hypersensitivity reactions
Metabolic side effects
thiazide diuretic mechanism of action
inhibits the Na+ - Cl- symporter in the early distal convoluted tubule and increase the reabsorption of calcium
thiazide diuretic therapeutic uses
hypertension
edema
nephrolithiasis or osteoporosis
diabetes
thiazide diuretic adverse effects
hypokalemia
hyperuricemia/gout
metabolic side effects: hyperglycemia, increased LDL and triglycerides
Hypersensitivity (SJS)
renal Na+ channel blocker mechanism of action
Blocks luminal Na+
channels in principal
cells of collecting duct
Not very effective diuretics
renal Na+ channel blocker therapeutic uses
used in combination with other diuretics
to treat edema and hypertension, to counterbalance the hypokalemia
Liddle’s Syndrome
renal Na+ channel blocker adverse effects
hyperkalemia, not to be used with K supplements or aldosterone receptor blockers or in patients with hyperkalemia
kidney stones
aldosterone receptor blocker mechanism of action
mineralcorticoid antagonist
reduces activation of basolateral Na/K pumps in the distal tubule and collecting duct, and epithelial sodium channels (ENaCs)
aldosterone receptor blocker therapeutic uses
used in combination with other diuretics to treat edema
and hypertension, to counterbalance the hypokalemia caused by loop and thiazide diuretics
Hyperaldosteronism
Congestive heart failure
Hepatic cirrhosis
aldosterone receptor blocker adverse effects
hyperkalemia, not to be used with K supplements or aldosterone receptor blockers or in patients with hyperkalemia
Antiandrogen effects: Spironolactone only. Eplerenone is more selective for the mineralocorticoid receptor
