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Pharmacology > Diuretics > Flashcards

Diuretics Flashcards

1
Q

What are diuretics

A

A drug or substance that increases the rate of urine secretion

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2
Q

What is the primary mechanism of Na+ transport in the proximal convoluted tubule

A

Na+/ H+ exchange

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3
Q

What are the classes of diuretics that work at the PCT

A

Carbonic anhydrase inhibitor
Osmotic diuretics

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4
Q

What is the prototypic agent of carbonic anhydrase inhibitors

A

Acetazolamide

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5
Q

MOA of acetazolamide

A

Inhibit of carbonic anhydrase in the brush border and cytoplasm

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6
Q

How is acetazolamide administered

A

Orally

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7
Q

Effects of acetazolamide

A

Metabolic acidosis
Potassium wasting (hypokalemia)
Acidosis of the cerebrospinal fluid causing hyperventilation

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8
Q

Clinical uses of acetazolamide

A
  • Treatment of severe acute glaucoma
  • Prevent acute mountain “high altitude” sickness
  • Diuretic effect only if the edema is accompanied by metabolic alkalosis
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9
Q

Topical analogs for carbonic anhydrase inhibitors

A
  • Dorzolamide
  • Brinzolamide
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10
Q

Mention osmotic diuretics

A
  • Mannitol
  • Glycerol
  • Isosorbide
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11
Q

How is Mannitol administered

A

Intravenously

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12
Q

MOA of mannitol

A

Increase concentration of solute in the tubular lumen and thus via osmosis promote excretion of water and electrolytes

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13
Q

Therapeutic use of mannitol

A
  • Reduce raised intracranial pressure
  • Reduce raised intraocular pressure in acute congestive glaucoma
  • Maintain osmolarity of extracellular fluid during dialysis
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14
Q

Adverse reactions of Mannitol

A

Hyponatremia
Pulmonary edema
Headache, nausea, and vomiting

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15
Q

Mention loop diuretics

A

Furosemide
Bumetanide
Tiracemide
Ethacrynic acid

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16
Q

Which part of the nephron do loop diuretics work on

A

Thick ascending limb

17
Q

How much sodium is filtered by the TAL

A

25%

18
Q

What cotransporter is found on the TAL

A

Na+/K+/2Cl-

19
Q

Clinical uses of loop diuretics

A
  • Congestive heart failure
  • Cirrhosis of the liver
  • Renal disease (nephrotic syndrome)

Short term management of ascites due to:
- Malignancy
- Idiopathic edema
- Lymphedema

Short term management of hospitalised pediatric patients

20
Q

How are loop diuretics used to treat disorders causing hypercalcaemia

A

By reducing the lumen voltage gradient that drives cation reabsorption in the loop, loop diuretics increase the excretion of divalent cations (Ca and Mg) and this can be useful in treating hypercalcaemia

21
Q

How are loop diuretics administered

A

Oral
Parenteral

22
Q

Adverse effects of loop diuretics

A
  • Hypokalemia, hyponatremia, hypocalcemia
  • Hyperglycaemia and hyperuricemia
  • Ototoxicity
23
Q

Important drug-drug interaction of loop diuretics

A

-Combinations with thiazide diuretics leads to potassium conservation and improved diuretic response

24
Q

What diuretics work at the distal convoluted tubule

A

Thiazide diuretics (hydrochlorothiazide)

25
Q

How much sodium is reabsorbed at the DCT

A

6 to 8%

26
Q

What happens in the body when it is in a hypertonic state

A

Anti diuretic hormone (ADH) is released by the posterior pituitary and increases the permeability and water reabsorption by the DCT.

27
Q

MOA of hydrochlorothiazide

A

To inhibit sodium chloride transport in the early segment of the DCT
Increases Na+/Cl- secretion

28
Q

Why are thiazides used to treat hypercalcinuria

A

When Na+ excretion is increased, Ca+ excretion is decreased

29
Q

Clinical uses of thiazides

A
  • Hypertension
  • Heart failure (reduce blood volume)
  • Treatment of kidney stones caused by hypercalcinuria
  • Nephrogenic diabetes insupidus
30
Q

How are thiazides administered

A

Orally

31
Q

Adverse reactions of thiazides

A
  • Hypokalemic metabolic alkalosis
  • Hyperuricemia caution in gout
  • Hyperglycaemia
  • Electrolyte imbalance
32
Q

Mention drugs under potassium sparing diuretics

A
  • Aldosterone antagonists: Spironolactone
  • Non steroidal potassium sparing drugs: triamterene and amiloride
33
Q

Function of aldosterone

A

Stimulates the rates of Na+ reabsorption and K+ secretion

Pharmacology (3 decks)

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