Diuretic and Antidiuretic

Question 0

Furosemide, Torsemide, Bumetanide and Ethacrynic Acid

Answer 0

Loop diuretics: Inhibit NaK2Cl cotransport system at TAL
Uses: acute pulm edema, CHF, HTN
Tox: hypokalemia (K stay in lumen), metabolic alkalosis, hyperuricemia, diabetogenic hyperglycemia, cross-sensitive to other SULFONAMIDES

Question 1

Acetazolamide and Methazolamide

Answer 1

Carbonic anhydrase, blocks reentry of bicarbonate and Na
Glaucoma, altitude sickness
Tox: systemic acidosis

Question 2

Hydrochlorothiazide and Indapamide

Answer 2

Thiazides, inhibition of NaCl cotransport/symporter at DCT
Uses: CHF, HTN, diabetes insipidus, decrease formation of Ca++ stones (Ca retention –> good for osteoperosis!)
Tox: HyperGLUC (glycemia, lipidemia. Uricemia, calcemia)
1)hypokalemia, 2)alkalosis (H go out with K, or Cl excretion lead to inc bicarbonate prod), 3)inc of PLASMA CHOLESTEROL and TG, 4)sulfa sensitivity (photosensitivity, rash)

Question 3

Spironolactone and Eplerenone, Amiloride and Triamterene

Answer 3

K sparing, late distal tubule and CD
Spironolactone and Eplerenone = Aldosterone R antagonists
Amiloride and Triamterene = Na influx blockers
Uses: renin-angiotensin HTN and CHF, hypokalemia effect of loops and thiazides
Tox: hyperkalemia and acidosis

Question 4

Mannitol

Answer 4

Osmotic diuretic, filtered at glomerulus but poorly reabsorbed –> holds water.
Tox: hyponatremia

Question 5

Vasopressin and Desmopressin

Answer 5

Antidiuretic:
Vasopressin: V1, V2; Desmopressin: V2
Both reduce urine volume and inc its concentration