Diuretic AntiHTN Flashcards
What type of diuretic is hydrochlorothiazide?
Thiazide diuretic
Blocks NA+ ATPase in upper end of ascending loop of Henle and first segment distal tubule
What is the MoA of hydrochlorothiazide?
Blocks NA+ ATPase in upper end of ascending loop of Henle and first segment distal tubule
What are the main uses of hydrochlorothiazide?
Mild hypertension, edema
Limited effectiveness if GFR is low
What are the side effects of hydrochlorothiazide?
Dehydration, hypo-electrolytes (Na, K, Cl)
Risk with digoxin and lithium because of the low Na
What type of diuretic is furosemide?
Loop diuretic
Blocks Na+ reabsorption that is coupled to Cl- ATPases along entire length of ascending loop of Henle
What is the MoA of furosemide?
Blocks Na+ reabsorption that is coupled to Cl- ATPases along entire length of ascending loop of Henle
most powerful class of diuretics (loop)
What are the main uses of furosemide?
Pulmonary edema,
regular cardiac edema,
heart failure, hypertension
What are the side effects of furosemide?
Dehydration, hypo-electrolytes (Na, K, Cl)
Risk with digoxin and lithium, dehydration, ototoxicity (with high doses);
monitor electrolytes and renal function
What type of diuretic is amiloride?
Potassium-sparing diuretic
Inhibits NA+ ATPase that is indirectly linked to K+/H+ exchange in the distal tubule
What is the MoA of amiloride?
Inhibits NA+ ATPase that is indirectly linked to K+/H+ exchange in the distal tubule;
prevents development of hypokalemia
this class of diuretics is often combined with other classes of diuretics
What are the main uses of amiloride?
Hypertension, edema, heart failure
Prevents development of hypokalemia; often combined with other classes of diuretics
What are the side effects of amiloride?
Hyperkalemia risk and endocrine side effects
Monitor serum potassium and renal function, especially when used with other potassium-sparing agents
What endocrine effects can amiloride cause?
Gynecomastia, menstrual irregularities, impotence, hirsutism, deepening of voice
What type of diuretic is eplerenone?
Aldosterone antagonist (K+ sparing)
An aldosterone receptor antagonist which regulates Na+ ATPase enzyme linked to K+/H+ exchange in the distal tubule
What is the MoA of eplerenone?
an aldosterone receptor antagonist which normally functions to regulate the Na+ ATPase enzyme that is linked to K+/H+ exchange in the distal tubule
binds to MR (mineralcorticoid receptor)
What are the main uses of eplerenone?
Hypertension, heart failure (post-MI), edema
Functions to regulate sodium and potassium levels
What are the side effects of eplerenone?
Hyperkalemia, hypotension and endocrine side effects
Requires monitoring of potassium levels and renal function
What endocrine effects can eplerenone cause?
Gynecomastia, menstrual irregularities, impotence, hirsutism, deepening of voice
Less endo effects than spironol bc this one more specific to MR
endocrine effects ESP w/aldosterone antag bc it’s a steroid receptor and drug may bind to wrong steroid receptor, like estrogen receptor
What type of diuretic is acetazolamide?
(diamox)
Carbonic anhydrase inhibitors
Blocks the breakdown of HCO3- in the proximal convoluted tubule
What is the MoA of acetazolamide?
Blocks the breakdown of HCO3- in the proximal convoluted tubule, causing diuresis due to sodium retention.
makes urine alkalized
What is a key effect of acetazolamide?
Makes urine alkalized
What are the main uses of acetazolamide?
Used as a diuretic and to treat glaucoma
Also used in conditions requiring urine alkalinization
What are the side effects of acetazolamide?
Metabolic acidosis, electrolyte imbalances (hypo Na, K)
CNS disturbances: malaise, anorexia, fatigue, paresthesias, depression; GI disturbances: vomiting, diarrhea
What type of diuretic is mannitol?
Osmotic diuretic
High solute load pulls water into the PCT for diuresis
What are the side effects of mannitol?
Risk of dehydration, hypernatremia, electrolyte imbalances
Monitor fluid balance and serum electrolytes; can cause edema if it leaks from vascular bed
What are the main uses of mannitol?
Elevated intracranial pressure, acute glaucoma
Very effective to draw water from the brain
Does mannitol cross BBB?
no, it does not cross BBB
What 2 types of diuretics can cause states of hypokalemia?
thiazide and loop diuretics can cause states of hypokalemia
Besides photophobia, what is another possible side effect of all diuretics?
cross sensitivity allergic rxn if allergic to sulfa drugs
The toxicity of what meds get increased w/diuretics?
lithium, incr ototoxicity of NSAIDS & aminoglycoside abx
Diuretics are pregnancy category ___.
B-C
Chemical composition of filtrate constantly changes d/t ____.
different expression of transport proteins and passive diffusion of water in specific areas
