diuretic drugs

Question 1

what class of drug is acetazolamide

Answer 1

carbonic anhydrase inhibitor

Question 2

what is the MOI of acetazolamide

Answer 2

inhibits CA intracellularly and on prox tubule; dec Na exchange - weak diuresis
CA catalyzes bicarb reaction- elevate urine pH

Question 3

what are the therapeutic uses of acetazolamide

Answer 3

chronic glaucoma- dec production of aqueous humor

prevents mountain sickness

Question 4

what are ADR of acetazolamide

Answer 4

metabolic acidosis, K depletion, drowsy, paresthesia

avoid in cirrhosis- can cause dec NH4 excrete

Question 5

what are 4 loop diuretics that act on the ascending loop

Answer 5

bumetanide (potent), furosemide (most common), torsemide, and ethacrynic acid (more ADE)

Question 6

what is the MOI of loop diuretics

Answer 6

inhibit cotransport of NA/K/CL in luminal membrane of the ascending loop. decrease resorption of these ions

Question 7

T/F loop diuretics inc CA content of urine , whereas thiazide diuretics dec? does this result in hypo/hyper calcemia?

Answer 7

true; not in pts c/ normal CA serum lvls because CA is reabsorbed in distal convoluted tubule. however, hypoMg can occur

Question 8

T/F loop diuretics cause inc renal vascular resistance and decrease renal blood flow

Answer 8

false, opposite

Question 9

what other meds should you avoid while taking a loop diuretic

Answer 9

NSAIDS e.g. endomethacin- interfere c/ prostaglandin synth- reduce diuretic axn

Question 10

what are the therapeutic uses of loop diuretics

Answer 10

acute pulmonary edema of HF, hypercalcemia, hyperkalemia

Question 11

what are some ADR of loop diuretics

Answer 11

ototoxicity, hyperuricemia, hypotension, hypokalemia, hypomagnesemia

Question 12

T/F loop diuretics are called ceiling diuretics

Answer 12

False - high ceiling

thiazide diuretics are ceiling

Question 13

where do thiazide diuretics act

Answer 13

affect the distal tubule

Question 14

what is the MOI of thiazide diuretic

Answer 14

decrease resorption of Na

Question 15

actions of a thiazide is to inc excretion of Na and Cl, dec urinary Ca excretion and reduce peripheral vascular resistance

Answer 15

true

Question 16

what are therapeutic uses for thiazide diuretics

Answer 16

HTN, HF, hypercalciuria, diabetes insipidus

Question 17

ADR thiazide diuretics

Answer 17

hypokalemia, hyperuricemia, hypotension, hyponatremia, hypercalcemia, hyperlipidemia

Question 18

what diuretic should you avoid if sulfa hypersensitive

Answer 18

thiazide

Question 19

what are some K sparing diuretics

Answer 19

spironolactone, eplerenone, triamterine, amiloride, hydrochloride

Question 20

what is the MOI of K sparing diuretics

Answer 20

antagonizes aldosterone at intracellular cytoplasmic receptor sites, prevents Na reabsorption and therefore K and H secretion

Question 21

what are the therapeutic uses of K sparing diuretics

Answer 21

2nd hyperaldosteronism, HF

Question 22

what would you give in conjunction with a thiazide or loop diuretic to prevent K excretion

Answer 22

spironolactone- K sparing

Question 23

ADR and K sparing

Answer 23

GI upset and peptic ulcer, gynecomastia and menstrual irregularities, hyperkalemia, nausea, lethargy, mental confusion

Question 24

triamterene and amiloride MOA

Answer 24

block Na transport channels, resulting in dec Na/K exchange

Question 25

what is the difference between spironolactone and triamterene and amiloride

Answer 25

their ability to block Na/K exchange is aldosterone independent e.g. Addison dz

Question 26

ADE of triamterine

Answer 26

leg cramps, inc BUN, inc uric acid, K retention

Question 27

are osmotic diuretics useful for treating conditions in which Na retention occurs?

Answer 27

no, used for maintaining urine flow - acute renal failure following toxic ingestion, trauma, shock, inc intracranial press,

Question 28

ADR and Mannitol

Answer 28

extracellular water expansion, dehydration, hypo/hypernatremia