Diuretics Flashcards
Acetazolamide
Proximal convoluted tubule 前段
Inhibit carbonic anhydrase
Sulfonamide derivative 磺胺類
利尿劑
Cause
Lumen H2CO3 increase
Antidote
Aspirin
Toxicity
Hyperchloremic metabolic acidosis
Renal stone
Hyperammonemia
Renal K+ wasting lead to 心律不整
磺胺類過敏
Treat
Glaucoma
Mountain sickness 高山症
Epilepsy 癲癇
鹼化尿液
Furosemide
Loop of Henle （效力最強）
Block NKCC absorption
利尿劑
Treat
Acute Hyperkalemia
Acute renal failure
Br/F/I overdose
Hypertension
急性肺水腫首選
急性高血鈣
Side effect
HMA
Hear loss
Hyperuricemia
Gout 痛風
Toxicity
Hypomagnesemia
Allergic rxn
耳/腎毒性（with aminoglycoside)
Bumetanide
Loop of Henle
Block NKCC absorption
利尿劑
Treat
Hyperkalemia
Acute renal failure
Br/F/I overdose
Hypertension
Side effect
HMA
Hear loss
Hyperuricemia
Gout 痛風
Toxicity
Hypomagnesemia
Allergic rxn
Ethacrynic acid
Loop of Henle
Block NKCC absorption
利尿劑
Treat
Hyperkalemia
Acute renal failure
Br/F/I overdose
Hypertension
Side effect
HMA
Hear loss
Hyperuricemia
Gout 痛風
Toxicity
Hypomagnesemia
Allergic rxn
Hydrochlorothiadize
Distal convoluted tubule
Thiadize class
Cause
Inhibit NaCl co-transporter
Some inhibition of CA at PCT
利尿劑
Treat
高血壓首選
心衰竭
腎結石（高尿鈣）
腎因性尿崩
Toxicity
HMA
Hyperuricemia
hyperglycemia
hyperlipidemia
Hyponatremia (low Na+)
Allergic rxn
Impotence 陽痿
心律不整
鹼中毒
Indapamide
Distal convoluted tubule
Thiadize class
Cause
Inhibit NaCl transporter
Some inhibition of CA at PCT
利尿劑
抗高血壓劑
Toxicity
HMA
Hyperuricemia
Inhibit insulin release, hyperglycemia
Increase LDL, hyperlipidemia
Hyponatremia (low Na+)
Allergic rxn
Impotence 陽痿
Increase cholesterol concentration
心律不整
Chlorthalidone
Distal convoluted tubule
Thiadize class
Cause
Inhibit NaCl transporter
Some inhibition of CA at PCT
利尿劑
Treat
Hypertension 首選
心衰竭
腎結石
腎因性尿崩
Toxicity
HMA
Hyperuricemia
hyperglycemia
hyperlipidemia
Hyponatremia (low Na+)
Allergic rxn
Impotence 陽痿
心律不整
鹼中毒
Metolazone
Distal convoluted tubule
Thiadize class
Cause
Inhibit NaCl transporter
Some inhibition of CA at PCT
利尿劑
抗高血壓劑
Toxicity
HMA
Hyperuricemia
Inhibit insulin release, hyperglycemia
Increase LDL, hyperlipidemia
Hyponatremia (low Na+)
Allergic rxn
Impotence 陽痿
Increase cholesterol concentration
心律不整
Quinethazone
Distal convoluted tubule
Thiadize class
Cause
Inhibit NaCl transporter
Some inhibition of CA at PCT
利尿劑
抗高血壓劑
Toxicity
HMA
Hyperuricemia
Inhibit insulin release, hyperglycemia
Increase LDL, hyperlipidemia
Hyponatremia (low Na+)
Allergic rxn
Impotence 陽痿
Increase cholesterol concentration
心律不整
Amiloride
Collecting duct
阻斷ENaC
儲鉀利尿劑
Cause
Apical ENaC inhibition (Na channel)
Inhibit Apical K+ excretion
Treat
Hypertension
Side effect
高血鉀酸中毒
Conivaptan
Collecting duct
減少水分再吸收
Intravenous only
Inhibit V1 & V2 receptor
儲鉀利尿劑
Treat
Hypertension
Tolvaptan
Collecting duct
減少水分再吸收
Oral only
Inhibit V2 receptor
儲鉀利尿劑
Treat
Hypertension
Spironolatone
Collecting duct
Inhibit ADH
醛固酮receptor antagonist
儲鉀利尿劑
Treat
Mineralocorticoid excess
Hypertension
肝硬化病人水腫
高醛固酮血症
Toxicity
Hyperkalemia
HMA
(With spironolactone)
Gynecomastia 男性乳房發育症
Impotence
(With triamterene + indomethacin
Acute renal failure
(With triamterene)
Kidney stone
(With strong CYP3A4 inhibitor)
Eplernone accumulation
Mannitol
Proximal convoluted tubule
Thin poop of Henle
Collecting duct
Osmotic 型利尿劑
Cause
ADH inhibition
Inhibit H2O absorption
Treat
For 降低眼壓和顱內壓
Toxicity
Hypernatremia
水腫
Eplerenone
保鉀型利尿劑
醛固酮receptor antagonist
Treat
肝硬化病人水腫
高醛固酮血症
Side effect
高血鉀酸中毒
