CV Oedema Flashcards
what are the 2 TYPES OF OEDEMA?
Water retention in the system
Pulmonary- lungs
Peripheral- rest of the body (ankle swelling)
4 types of diuretics
thiazide
loop
K+ sparing
aldosterone antagonists
thiazide diuretics examples
Bendroflumethiazide, Indapamide
how do thiazide diuretics work and when should they be given time of day
Inhibit sodium reabsorption at beginning of the distal convoluted tubule
Lasts up to 24hrs- needs to be given AM to avoid sleep disruption
loop diuretics examples
Furosemide, Bumetanide, Torasemide
how do loop diuretics work
Inhibits reabsorption from the ascending limb of the loop of Henle
Used in pulmonary oedema due to left ventricular failure
when do loop diuretics have to be given time of day
Lasts 6hrs, can give BD, no disruption to sleep
examples of K+ sparing diuretics
Amiloride, Triamterene (blue urine)
how do K+ sparing diuretics work
Prevents sodium reabsorption in the distal tubule collecting duct
examples of ALDOSTERONE ANTAGONISTS
Spironolactone, Epleronone
how do aldosterone antagonists work
Inhibits potassium secretion in the distal tubule collecting duct
Stopped if person becomes dehydrated- vomiting/diarrhoea
which 2 diuretics must NOT be taken with K+ supplements?
K+ sparing and aldosterone antagonists (mineralocorticoid receptor antagonist)
inc risk of hyperkalaemia
DIURETICS SIDE-EFFECTS
ALL?
Induce hyponatraemia + hypomagnesaemia
all lower Na and Mg
DIURETICS SIDE-EFFECTS
LOOP+THIAZIDE?
Hypokalaemia
Exacerbates diabetes+exacerbates gout (inc BG lvls and uric acid)
Hypotension
DIURETICS SIDE-EFFECTS
K+-SPARING?
Hyperkalaemia
Change in libido
Breast pain/tenderness
DIURETICS- INTERACTIONS
Loop+Thiazide?
hypokalaemia inducing drugs
DIURETICS- INTERACTIONS
K+sparing?
hyperkalaemia inducing drugs
DIURETICS- INTERACTIONS
Loop+Aminoglycosides?
nephrotoxicity/ototoxicity (gent)
DIURETICS- INTERACTIONS
Thiazide/Spironolactone/Loop+Lithium?
reduces lithium secretion (renal)
as they all inc Li conc.
loop and spironolactone can reduce Li scretion causing Li TOX!
2 TYPES OF PERIPHERAL VASCULAR DISEASE?
OCCLUSIVE VASCULAR DISEASE
VASOSPASTIC VASCULAR DISEASE (Raynaud’s)
what is OCCLUSIVE VASCULAR DISEASE
Normally caused by atherosclerosis
Reduced risk with healthier lifestyle, statins & antiplatelets
what is VASOSPASTIC VASCULAR DISEASE (Raynaud’s)
Avoid exposure to cold+smoking cessation - constricts BV and makes it worse
Further treatment? NIFEDIPINE! CCB that helps relax smooth muscle in BV, widening them and improving circulation
