Diuretic Actions

Question 0

Categories of Diuretics

Answer 0

Loop, Thiazide, CA Inhibitor, Thiazide-like

Question 1

Common uses for diuretics

Answer 1

CHF, Hepatic Ascites, HTN, Nephrotic syndrome

Question 2

CA inhibitors

Answer 2

Causes Bicarb to be retained in urine
Na can’t be exchanged for H, so Na in urine
Water follows, so diuresis
Urine is alkali if, get metabolic acidosis

Question 3

CA inhibitor affect on urine

Answer 3

Increased volume, Na, K, and HCO3

Clinically useful for trapping chemicals in urine (not used on CPB)

Question 4

Side effects of Acetzolamide (Diamox)

Answer 4

Glaucoma, high altitude sickness

Question 5

Nickname for loop diuretics

Answer 5

High ceiling diuretics (dose response curve is nearly linear)
Yellow zipper drugs
Non potassium sparing
Chemical hemoconcentrator

Question 6

Loop diuretic MOA

Answer 6

Block co transport of Na, K, 2Cl from tubular lumen back into circulation–So much left that nephron can’t compensate and it’s lost in urine
Increase RBF by expressing COX2 which produces prostaglandins (vasodilator)

Question 7

Loop diuretic affect on urine

Answer 7

Increased Na, K, Ca, and volume

Question 8

Perfusion uses of loop diuretics

Answer 8

Get rid of excess fluid
Get rid of excess K
Maintain UO and renal function

Question 9

Loop diuretic side effects

Answer 9

Ototoxicity
Hypokalemia
Hypotension
Hypomagnesemia
Hyperuricemia

Question 10

Nickname for Thiazide diuretics

Answer 10

Ceiling diuretics

Question 11

Thiazide diuretic MOA

Answer 11

Blocks Na/Cl reabsorption on LUMINAL side of ascending loop and distal convoluted tubule
Increases RBF through COX2 prostaglandin synthesis

Question 12

Only Thiazide available for parenteral use

Answer 12

Chlorothiazide

Question 13

Thiazide diuretic effect on urine

Answer 13

Increased volume, Na, and K

Decreased Ca

Question 14

Thiazide diuretic perfusion uses

Answer 14

Get rid of excess fluid
Decrease SVR
Increase Ca reabsorption
HTN

Question 15

K sparing diuretic MOA

Answer 15

Prevent Na reabsorption and K excretion

Antagonize aldosterone

Question 16

GFR layers of adrenal medulla

Answer 16

Glomerulosa: mineralocorticoids (aldosterone)
Fasciculata:glucocorticoids (cortisol)
Reticularis: androgens (testosterone precursors)

Question 17

K sparing diuretic affect on urine

Answer 17

Increased Na and volume

Decreased K

Question 18

Types of potassium sparing diuretics

Answer 18

Direct and indirect aldosterone antagonists

Question 19

Indirect aldosterone antagonist MOA

Answer 19

Block Na channels used by aldosterone rather than aldosterone itself
Can be used in Addison’s patients (because have significant aldosterone)

Question 20

Osmotic diuretic perfusion relevance

Answer 20

Maintain urine flow following acts renal injury

Decrease cerebral edema

Question 21

1 rule when giving mannitol

Answer 21

Check bag for precipitated crystals