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CPR EXAM 2 > (3.1) Diuretics (Wolff) > Flashcards

(3.1) Diuretics (Wolff) Flashcards

1
Q

What are the (3) thaizide diuretics?

A

Hydrochlorothiazide

Metolazone

Chlorthalidone

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2
Q

What are the (4) loop diuretics?

A

Furosemide

Torsemide

Bumetanide

Ethacrynic acid

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3
Q

What are the K+ sparing diuretics (specifically the 2 Na+ channel blockers)?

A

Amiloride

Triamterene

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4
Q

What are the K+ sparing diuretics (specifically the 2 aldosterone antagonists)?

A

Spironolactone

Eplerenone

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5
Q

What is the carbonic anhydrase inhibitor?

A

Acetazolamide

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6
Q

What is the osmotic diuretic?

A

Mannitol

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7
Q

What are the (2) aquaretics?

A

”-vaptan”

Conivaptan

Tolvaptan

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8
Q

Define:

Diuretic

A

Substance that promotes the excretion of urine

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9
Q

Define:

Natriuetic

A

Substance that promotes the renal excretion of sodium

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10
Q

Define:

Aquaretic

A

Substance that produces free water clearance

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11
Q

What class of diuretics act at the proximal tubule?

A

Osmotic diuretics

Carbonic anhydrase inhibitors

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12
Q

What class of diuretics act at the thick ascending limb of henle?

A

Loop diuretics

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13
Q

What class of diuretics act at the distal convoluted tubule?

A

Thiazide

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14
Q

What class of diuretics act at the cortical collecting duct?

A

Na+ channel blockers

(spironolactone)

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15
Q

What class of diuretics act at the collecting duct?

A

-Vaptans

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16
Q

What are the common clinical reasons for administering diuretics?

A

Essential hypertension

Edema (associated with liver/kidney/congestive heart failure)

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17
Q

What’s a nice way to remember where the K+ losing vs K+ sparing diuretics act?

A

K+ losing act more proximal to the glomerulus

K+ sparing act more distal to the glomerulus

18
Q

Hyperkalemia causes _________ on EKGs

A

Hyperkalemia causes tall T waves on EKGs

19
Q

What is a paradoxical reaction of the heart to hyperkalemia?

A

BRADYCARDIA

20
Q

Hypokalemia causes _________ on EKGs

A

Hypokalemia causes flattened T waves and tall U waves on EKGs

21
Q

What is the mechanism of action of loop diuretics?

A

Block the Na+-K+-2Cl- cotransporter in the thick ascending limb

22
Q

Loop diuretics are efficacious even when ____ and ____ are low

A

Loop diuretics are efficacious even when RBF and GFR are low

23
Q

What are the adverse effects of loop diuretics?

A

Hypokalemia

Hypomagnesemia

Hypocalcemia

Ototoxicity

24
Q

What drug is among the few diruetics that can be used by people who are allergic to “sulfa drugs”?

A

Ethacrynic acid

25
Q

What is the mechanism of action of thiazides?

A

Block the Na-Cl cotransporter in the distal convoluted tubule

26
Q

Thiazides do NOT work well with _____ and/or ______

A

Thiazides do NOT work well with low RBF and/or low GFR

27
Q

Thizide diuretics are indicated for?

A

Primary hypertension

Nephrogenic diabetes insipidus

28
Q

What are the adverse effects of Thiazide diuretics?

A

Hypovolemia

K+ losing

Hypochloremic metabolic alkalosis

Hypomagnesemia

29
Q

What is the mechanism of action of K+ sparing diuretics?

A

Can be one of two mechanisms…

1) (Amiloride) Blocks the luminal Na+ channels in the collecting duct
2) (Spironolactone) Blocks the Aldosterone receptor in the collecting duct

30
Q

Na+ channel blockers (amiloride and triamterene) exert their effects…

A

QUICKLY!!!

Since the channel is blocked directly, effects are seen more rapidly than with spironolactone

31
Q

What is the mechanism of action of spironolactone?

A

Blocks the ability of aldosterone to bind to its receptor

–> leads to increased Na+ excretion and decreased K+ excretion

32
Q

What is notable about the pharmacokinetics of spironolactone?

A

Can take 48 hours to work!!!

SO SLOW

33
Q

What are the adverse effects of spironolactone?

A

Hyperkalemia

Endocrine effects (gynecomastia, impotence, menstrual irregularities, hirsutism and deepening voice)

34
Q

What is the mechanism of action of the vaptans?

A

Block the antidiuretic hormone receptor in the collecting duct

35
Q

What is the mechanism of action of acetozolamide?

A

Inhibits carbonic anhydrase

36
Q

What are the indications for acetozolamide?

A

Urinary alkalinization

Glaucoma

Acute mountain sickness

37
Q

What are the adverse effects of acetazolamide?

A

Hyperchloremic metabolic acidosis

Renal stones

Potassium wasting

38
Q

What is the mechanism of action of mannitol?

A

Mannitol is a non-metabolized sugar, freely filtered with minimal reabsorption

The inability to reabsorb this solute keeps water in the proximal tubule lumen; this water is delivered to the distal portions of the nephron where much of it is excreted

39
Q

The net effect of administering mannitol is to…

A

Excrete total body water in excess of plasma electrolytes

40
Q

What is noteworthy about the pharmacokinetics of mannitol?

A

Given in GRAMS!!!

A lot more than the other diuretics (eg 50-200grams)

41
Q

What are two examples of alternative medicine diuretics?

A

Herbal diuretics

Licorice

42
Q
A

CPR EXAM 2 (52 decks)

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