ascites Flashcards
1
Q
name some aldosterone antagonists
A
spironoloactone
eplerenone
2
Q
indications for aldosterone antagonists
A
- ascites and oedema due to liver cirrhosis
- spiro = 1st line - chronic HF - at least moderate or in 1 month of MI - with BB and ACE-I/ARB
- primary hyperaldosteronism - those not wanting surgery or awaiting surgery
3
Q
moa aldosterone antagonists
A
- competitively bind to aldosterone receptor. = increases na and h20 excretion and k+ retention.
4
Q
SE aldosterone anatagonists
A
- Hyperk+
- gynaecomastia
eplerenone less likely endo SE
- aldosterone antagonists = liver impairment and jaindice and cause of SJS
5
Q
do not give aldosterone anatagonists to what patient
A
- hyperkalaemia
- severe renal impairment
- addisons disease;already aldosterone deficient
- avoid or prescribe with caution in pregnant or lactating
6
Q
which aldosterone antagonists is licensed for HF only
A
- eplerenone
7
Q
what dose do you give spironolactone in ascites, and HF
A
Ascites; 100mg
HF - 25mg
8
Q
when should patients take spironolactone
A
with food
9
Q
indications for loop diuretics
A
- releif from SOB in acute pulmonary oedema with o2 and nitrates
- for symptomatic rx of fluid overload in CHF
- trat oedema.
10
Q
MOA loop diuretics
A
- on ascending limb of LOH: inhibit 2cl/na/k transporter
- direcet effect on blood vessels = dilatation of capacitance veins
11
Q
SE loop diuretics
A
- dehydration
- hypotension
- increased loss of electrolytes + indirect loss of mg, ca, h+
- hearing loss and tinnitus at high doses - as same transporter in endolymphatic system
12
Q
CI of loop diuretics
A
- hypovolaemia
- dehydration
13
Q
loops should be used cautiously in which patients
A
- hepatic encephalopathy
- severe hypokalaemia
- severe hypona
- chronic use - worsen gout as inhibit uricc acid excretion
14
Q
interactions with loop diuretics
A
- potential to affect drugs excreted by kidneys
- lithium - reduced
- digoxin toxicity high risk
- worsen SE aminoglycosides
15
Q
name loops
A
furosemide, bumetanide
