1. Diuretics Flashcards
What are the therapeutic uses of acetazolamide?
mountain sickness, glaucoma, alkalinize urine
Alkalinizing urine would promote the excretion of what type of toxin?
a weak acid
What are the potential side effects of acetazolamide?
metabolic acidosis (hyperchloric), drowsiness, hypokalemia, hypersensitivity (sulfa drug)
A mountain climber is preparing to scale Mount Everest. A physician prescribes him a drug to help prevent mountain sickness. What is the most likely method of action of this drug?
increasing Na/bicarb excretion in proximal tubule (CA inhibitor)
What is the MOA of hydrochlorothiazide?
inhibiting luminal Na/Cl cotransport in the distal tubule
A patient in your practice has osteoporosis and edema. What diuretic drug would be a good choice?
hydrochlorothiazide
A patient in your practice has gout and edema. Which diuretic drugs would be a bad choice?
hydrochlorothiazides
loop diuretics
What are the indications of hydrochlorothiazide?
HTN, CHF/other edema, DI, hypercalciuric renal stones, nephrotic syndrome (with spironolactone)
What drug combo is a good choice for nephrotic syndrome?
hydrochlorothiazide and spironolactone
A CHF patient also has kidney function problems, including a low GFR. Which two hydrochlorothiazide drugs are possible choices to prescribe him?
What other drug class would be a good choice?
metolazone, indapamide
loop diuretics like furosemide
A CHF patient is taking digitalis. Which drug do you want to avoid coadministering to avoid hypokalemia?
hydrochlorothiazide
You are treating a diabetic patient with CHF and hyperlipidemia. Which diuretic drugs would be a bad choice?
hydrochlorothiazides
loop diuretics
You want to prescribe a loop diuretic with a patient with known hypersensitivity to every sulfa drug she has been prescribed. Which drug is the best choice?
ethacrynic acid
What is the MOA of furosemide?
Inhibiting Na-K-2Cl symporter in the luminal membrane of the thick ascending loop of Henle
What are the indications of furosemide?
acute pulmonary edema, other edemas, HTN (ok for low GFR), hypercalcemia
A patient who is currently taking aminoglycosides is given a diuretic and develops hearing problems. What drug class was the patient prescribed?
loop diuretic
Which diuretic class is most likely to cause hypovolemia?
loop diuretics
Which drug classes can cause hypokalemia?
loop diuretics
thiazides
carbonic anhydrase inhibitors
What is the MOA of spironolactone and eplerenone?
aldosterone antagonists in the late distal tubule and collecting duct
What is the DOC to prevent edema in patients with hepatic cirrhosis or nephrotic syndrome?
spironolactone
A patient is prescribed a drug for primary hyperaldosteronism and develops gynecomastia. Which drug was prescribed?
spironolactone
What are the indications for eplerenone?
HTN, CHF post-MI
Which diuretics are sodium channel blockers in the late distal tubule and collecting duct?
triameterene, amiloride
Which diuretic drugs can be administered for secondary hyperaldosteronism
triamterene, amiloride
What are the indications for IV mannitol?
increased ICP, maintain urine flow (toxicity, shock), glaucoma
What is the mechanism of action of acetazolamide?
blocking Na and bicarb reabsorption in the proximal tubule
What is the DOC IN HEPATIC CIRRHOSIS PATIENTS?
spironolactone
What sort of metabolic derangement does acetazolamide cause?
hypokalemic acidosis
Which drugs are not useful in patients with aldosterone deficiency?
spironolactone
eplerenone
Which diuretic class causes the worst hypokalemia?
CA inhibitors
