ADH and Diuretics--Trachte Flashcards
Furosemide
MOA
Tox
TU
MOA: inhibit NKCC2 symporter in thick ascending loop, creating hyperosmotic solution
Tox: hearing impairment (NKCC also found in cochlea)
TU: pulmonary edema, other edematous conditions, hyperkalemia, acute renal failure, anion overdose (Br-, F-, I-)
Bumetanide
MOA
Tox
TU
MOA: inhibit NKCC2 symporter in thick ascending loop, creating hyperosmotic solution
Tox: hearing impairment (NKCC also found in cochlea)
TU: pulmonary edema, other edematous conditions, hyperkalemia, acute renal failure, anion overdose (Br-, F-, I-)
Hydrochlorothiazide
MOA
Tox
TU
MOA: inhibit Na+/Cl- symporter in distal convoluted tubule, also inhibits sulfano-urea K+ receptor in vascular sm. muscle and pancreatic beta cells
Tox: hyperglycemia (K+ channel block in pancreatic beta cells → hyperpolarization → no insulin release → hyperglycemia)
TU: HTN
Chlorthalidone
MOA
Tox
TU
MOA: inhibit Na+/Cl- symporter in distal convoluted tubule, also inhibits sulfano-urea K+ receptor in vascular sm. muscle and pancreatic beta cells
Tox: hyperglycemia (K+ channel block in pancreatic beta cells → hyperpolarization → no insulin release → hyperglycemia)
TU: HTN
Metalazone
MOA
Tox
TU
MOA: inhibit Na+/Cl- symporter in distal convoluted tubule, also inhibits sulfano-urea K+ receptor in vascular sm. muscle and pancreatic beta cells
Tox: hyperglycemia (K+ channel block in pancreatic beta cells → hyperpolarization → no insulin release → hyperglycemia)
TU: HTN
Amiloride
MOA
Tox
TU
MOA: inhibits ENaC in collecting tubule, decreasing K+ charge buffer w/ Na+, reducing K+ secretion
Tox; hyperkalemia, hyperchloremic metabolic acidosis
TU: hyperaldosteronism, preventing K+ wasting from other diuretics
Triamterene
MOA
Tox
TU
MOA: inhibits ENaC in collecting tubule, decreasing K+ charge buffer w/ Na+, reducing K+ secretion
Tox; hyperkalemia, hyperchloremic metabolic acidosis
TU: hyperaldosteronism, preventing K+ wasting from other diuretics
Spironolactone
MOA
Tox
TU
MOA: inhibits SRE (steroid response element) → decrease in expression of ENaC and ROMK
Tox: hyperkalemia, hyperchloric metabolic acidosis, gynecomastia
TU: hyperaldosteronism, prevents K+ wasting caused by other diuretics
Eplerenone
MOA
Tox
TU
MOA: inhibits SRE (steroid response element) → decrease in expression of ENaC and ROMK
Tox: hyperkalemia, hyperchloric metabolic acidosis
TU: hyperaldosteronism, prevents K+ wasting caused by other diuretics
Desmopressin
MOA
Tox
TU
MOA: mimics ADH, inserts aquaporins into collecting duct → increased H2O reabsorption
Tox:?
TU: low-volume state (?)
Mannitol
MOA
Tox
TU
MOA: filtered into Bowman’s space and not reabsorbed in nephron → diuresis
Tox: extracellular volume expansion, dehydration, hypernatremia, hyperkalemia, hyponatremia w/ impaired renal function
TU: diuresis, decrease intraoccular and intracranial pressure
Giflozin
Canigliflozin
Dopagliflozin
MOA
Tox
TU
MOA: inhibit Na+/Glc symporter in proximal tubule
Tox: ketoacidosis, UTIs, yeast infections, hypoglycemia
TU: adjuctive Tx of DM
Acetazolamide
MOA
Tox
TU
MOA: carbonic anhydrase inhibitor, decreases activity of Na+/H+ antiporter
Tox: many: hyperchloremic metabolic acidosis, renal stones, K+ wasting
TU: glaucoma, urinary alkylization, metabolic acidosis, acute altitude sickness
Probenicid
MOA
Tox
TU
MOA: inhibit uric acid transporters in proximal tubule, preventing reabsorbtion
Tox: (?)
TU: gout
