pharmacology: diuretics Flashcards Preview

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Flashcards in pharmacology: diuretics Deck (20):
1

what are the categories of diuretics?

osmotic diuretics, carbonic anhydrase inhibitors, loop diuretics, thiazides, K+ sparing agents

2

what are the osmotic diuretics?

mannitol (IV) - inhibits water reabsorption throughout the tubule which increases urine volume

3

mannitol uses and side effects

uses: decreases IOP in glaucoma
decreases intracerebral pressure
oliguric states (rhabdo)

SE: acute hypovolemia

4

what are the carbonic anhydrase inhibitors? mechanism?

acetazolamide and dorzolamide
mechanism: carbonic anhydrase inhibition resulting in:
decreased H formation inside PCT cell
decreased Na/H antiport
increased NA and HCO3 in lumen
increased diuresis

5

carbonic anhydrase inhibitors uses

glaucome, acute mountain sickness, metabolic alkalosis (loss of bicarb)

6

carbonic anhydrase inhibitors side effects

bicarbonaturia and acidosis with hypokalemia******
hyperchloremia
paresthesias
renal stones
sulfonamide hypersensitivity

7

what are the loop diuretics? mechanism?

ethacrynic acid and furosemide
mechanism: Na/K/2Cl transporter inhibition resulting in:
decreased intracullular K in TAL
decreased back diffusion of K
decreased positive potential
decreased reabsorption of Ca and Mg
increased diuresis

8

ethacrynic acid and furosemide uses

acute pulmonary edema, heart failure, hypertension, refractory edemas, acute renal failure, anion overdose, hypercalcemic states

9

ethacrynic acid and furosemide side effects

sulfonamide hypersensitivity (furosemide)
hypokalemia and alkalosis
hypocalcemia
hypomagnesemia
hyperuricemia
ototoxicity

10

ethacrynic acid and furosemide drug interactions

aminoglycosides (enhanced ototoxicity)
lithium (chronic loop administration, decreased clearance)
digoxin (increased toxicity due to electrolyte disturbances)

11

what are the thiazides? mechanism?

hydrochlorothiazide and indapamide
mechanism: Na/Cl transporter inhibition resulting in:
increased luminal Na and Cl in DCT
increased diuresis

12

thiazides (hydrochlorothiazide and indapamide) uses

HTN, CHF
nephrolithiasis (calcium stones)
nephrogenic diabetes insipidus

13

thiazides (hydrocholorthiazide and indapamide side effects

sulfonamide hypersensitivity
hypokalemia and alkalosis
hypercalcemia
hyperuricemia
hyperglycemia
hyperlipidemia

14

hydrochlorothiazide and indapamide drug interactions

digoxin
avoid in DM

15

what are the K sparing agents

spironolacton, amiloride, triamterene

16

spironolactone mechanism and uses

mechanism: aldosterone-receptor antagonist
uses: hyperaldosteronic state
adjunct to K wasting diuretics
antiandrogenic uses (female hirsutism)
CHF

17

spironolactone side effects

hyperkalemia and acidosis
antiandrogen (eplerenone selective)

18

amiloride and triamterene mechanism, use, side effects

mechanism: Na channel blockers
use: adjunct to K wasting diuretics, lithium induced nephrogenic diabetes insipidus
side effects: hyperkalemia and acidosis

19

which diuretics cause blood acidosis?

acetazolamide (secretion of HCO3), amiloride, tramterene, spironolactone, eplerenone

20

which diuretics cause blood alkalosis

ethacrynic acid, furosemide, hydrochlorothiazide, indapamide