Anti-hypertensive drugs altering Na & H2O balance/diuretics

Question 1

Which types of diuretics can exacerbate hyperuricemia?

Answer 1

Thiazide and loop diuretics

Question 2

The musculoskeletal toxicity of thiazides includes

Answer 2

hyperuricemia/gout

Question 3

The mechanism of action of thiazide diuretics is the inhibition of _______ at the early distal convoluted tubule, promoting water and sodium loss. It also has direct action on vascular smooth muscle which causes vasodilatation and reduces peripheral resistance, as a result, causing blood pressure to be lowered.

Answer 3

NaCl symporters

To sum up, thiazide diuretics have diuresis action and cause decreased peripheral resistance. Effective in treating mild-moderate hypertension

Question 4

What type of diuretic is Indapamide?

Answer 4

thiazide-like diuretics

Question 5

Thiazides are always used in combination with _________ when treating HF heart failure

Answer 5

furosemide

Question 6

What is the MOA of thiazide diuretics?

Answer 6

Inhibition of NaCl reabsorption at the early distal tubule

Question 7

How do thiazide diuretics influence serum Ca levels?

Answer 7

increase

Question 8

Loop diuretics and ___________ are 2 types of diuretics that cause alkalosis due to volume contraction as a result of increased angiotensin II levels.

Answer 8

thiazide diuretics

Question 9

______________ diuretics both cause potassium excretion and a contraction alkalosis. (name the med class)

Answer 9

Loop and thiazide

Question 10

Which 2 types of diuretics cause alkalosis?

Answer 10

loop, thiazide

Question 11

According to the lecture, how many types of diuretics are there? List them.

Answer 11

Thiazide (hydrochlorothiazide)
Loop diuretics (furosemide/frusemide)
Aldosterone antagonists (spironolactone)

Question 12

Adverse effects of thiazide diuretics include?

Answer 12

Hypokalaemia
Mg depletion
Impaired glucose tolerance
Increased serum lipid
Increased uric acid (can precipitate gout)

Question 13

MOA of loop diuretics

Answer 13

acts on thick ascending limb of Henle’s loop and inhibits Na/K/Cl cotransporter, causing increased excretion of Na, Cl, K, Mg, Ca. Hence, reduced BV.

(greater efficacy than thiazide and potassium sparing diuretics)

Question 14

Therapeutic use of furosemide

Answer 14

in severe hypertension**

and also CHF, acute pulmonary oedema and hypercalcaemia

Question 15

adverse effects of furosemide

Answer 15

Fluid & electrolyte imbalance :hypokalaemia, magnesium depletion, dehydration
hyperuricaemia
ototoxicity

Question 16

Which is preferred as first line drug for African American patients with isolated hypertension?

Answer 16

Thiazide diuretics
Eg Chlorthalidone