Diuretics Flashcards

1
Q

Diuretics contains drugs which causes loss of

A

Na and water in urine

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2
Q

Which diuretic is non-specific and can act even outside of kidney

A

Osmotic diuretics

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3
Q

Which diuretic is non-specific and can act even outside of kidney

A

Osmotic diuretics

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4
Q

Conditions for Osmotic diuretics

A

Must be freely filtered by glomerulus
Should not be reabsorbed
Should exert Osmotic effect
Non reactable chemically

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5
Q

Example of Osmotic diuretics

A

Mannitol

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6
Q

Mannitol can be used in

A

Cerebral edema
Acute congestive Glaucoma
Partial or incipient Renal failure

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6
Q

Mannitol can be used in

A

Cerebral edema
Acute congestive Glaucoma
Partial or incipient Renal failure

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7
Q

Contraindications of Mannitol

A

During active cerebral hemorrhage - can aggravate edema
In case of complete renal failure
Pulmonary edema

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7
Q

Contraindications of Mannitol

A

During active cerebral hemorrhage - can aggravate edema
In case of complete renal failure
Pulmonary edema

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8
Q

Mannitol can be given orally in

A

Osmotic diarrhea

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8
Q

Mannitol can be given orally in

A

Osmotic diarrhea

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9
Q

Site of action of Carbonic anhydrase inhibitors

A

PCT of Nephron

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10
Q

Mechanism of action of Carbonic anhydrase inhibitor

A

Inhibits Carbonic anhydrase enzyme responsible for Sodium and Bicarbonate reabsorption

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11
Q

Mechanism of action of Carbonic anhydrase inhibitor

A

Inhibits Carbonic anhydrase enzyme responsible for Sodium and Bicarbonate reabsorption

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12
Q

Carbonic anhydrase inhibitor drugs

A

Acetazolamide oral or iv
Brinzolamide - Eyedrops
Dorzolamide - Eyedrops

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12
Q

Carbonic anhydrase inhibitor drugs

A

Acetazolamide oral or iv
Brinzolamide - Eyedrops
Dorzolamide - Eyedrops

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13
Q

Uses of Carbonic anhydrase inhibitors

A

G - Glaucoma
A - Alkalinization of urine - increased chances of renal stones
M - Mountain sickness (DOC)
E - Epilepsy

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14
Q

Side effects of Carbonic anhydrase inhibitors

A

Hypokalemia
Metabolic acidosis
Renal stones (calcium precipitates)
Paraesthesia

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14
Q

Side effects of Carbonic anhydrase inhibitors

A

Hypokalemia
Metabolic acidosis
Renal stones (calcium precipitates)
Paraesthesia

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15
Q

Site of action of Loop diuretics

A

Acts on thick ascending loop of Henle

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16
Q

Site of action of Loop diuretics

A

Acts on thick ascending loop of Henle

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17
Q

Loop diuretics drug examples

A

Furosemide
Torsemide
Bumetanide
Ethacrynic acid

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18
Q

Ethacrynic acid is not preferred now because of

A

It’s highly Ototoxic

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19
Q

Which diuretics also termed as High ceiling diuretics

A

Loop diuretics

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19
Q

Which diuretics also termed as High ceiling diuretics

A

Loop diuretics

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20
Q

Mechanism of action of Loop diuretics

A

Inhibits Na+ K 2Cl pump and let Sodium and water pass in urine

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20
Q

Mechanism of action of Loop diuretics

A

Inhibits Na+ K 2Cl pump and let Sodium and water pass in urine

21
Q

Common side effects of Loop diuretics and Thiazides

A

Hyponatremia
Hypokalemia
Hypomagnesemia
Metabolic alkalosis

Hyperglycemia
Hyperlipidemia
Hyperuricemia

21
Q

Common side effects of Loop diuretics and Thiazides

A

Hyponatremia
Hypokalemia
Hypomagnesemia
Metabolic alkalosis

Hyperglycemia
Hyperlipidemia
Hyperuricemia

22
Q

Difference in side effects of Loop diuretics and Thiazides

A

Loop diuretics - Hypocalcemia
Thiazides - Hypercalcemia

22
Q

Difference in side effects of Loop diuretics and Thiazides

A

Loop diuretics - Hypocalcemia
Thiazides - Hypercalcemia

23
Q

Uses of Loop diuretics

A

Edema
Hypertensive emergencies
Hypercalcemia
Bromide and iodide poisoning

24
Q

Site of action of Thiazides

A

Acts on DCT of Nephron

25
Q

Site of action of Thiazides

A

Acts on DCT of Nephron

26
Q

Mechanism of action of Thiazides

A

Blocks Na+ Cl- pump and Let pass sodium and water in urine

27
Q

Example of Thiazides

A

Chlorothiazide
Hydrochlorothiazide
Polythiazide

28
Q

Examples of Thiazide like diuretics

A

Chlorthalidone
Indapamide
Xipamide

29
Q

Uses of Thiazides

A

Osteoporosis - slowly increases calcium
Hypertension - 1st line drug
For recurrent Calcium stones in Kidney
Bromide and iodide Poisoning
Nephrogenic Diabetes insipidus

29
Q

Uses of Thiazides

A

Osteoporosis - slowly increases calcium
Hypertension - 1st line drug
For recurrent Calcium stones in Kidney
Bromide and iodide Poisoning
Nephrogenic Diabetes insipidus

30
Q

Diabetes insipidus occurs due to

A

Low levels of ADH

31
Q

Symptoms of Diabetes insipidus

A

Polyuria
Polydipsia

32
Q

Diabetes insipidus can be divided in two types

A

Decreased ADH from Posterior Pituitary - Central diabetes insipidus
OR
ADH not able to work on Kidney - Nephrogenic Diabetes insipidus

33
Q

Diabetes insipidus can be divided in two types

A

Decreased ADH from Posterior Pituitary - Central diabetes insipidus
OR
ADH not able to work on Kidney - Nephrogenic Diabetes insipidus

34
Q

Drug of Choice in central Diabetes insipidus

A

Desmopressin ( selective agonist of V2 receptor)

35
Q

Drug of Choice in central Diabetes insipidus

A

Desmopressin ( selective agonist of V2 receptor)

36
Q

DOC in Nephrogenic Diabetes insipidus

A

Thiazides

36
Q

DOC in Nephrogenic Diabetes insipidus

A

Thiazides

37
Q

Thiazides mechanism of action in Nephrogenic Diabetes insipidus

A

It inhibits dilution of urine - concentrated urine will be passed - leads to decreased plasma osmolarity - inhibition of thirst centre and increased diuresis

38
Q

Thiazides mechanism of action in Nephrogenic Diabetes insipidus

A

It inhibits dilution of urine - concentrated urine will be passed - leads to decreased plasma osmolarity - inhibition of thirst centre and decreased diuresis

39
Q

ADH retains

A

Only water

39
Q

ADH retains

A

Only water

40
Q

Example of ADH receptor antagonist

A

Tolvaptan

40
Q

Example of ADH receptor antagonist

A

Tolvaptan

41
Q

Site of action of Potassium sparing diuretics

A

Collecting duct

41
Q

Site of action of Potassium sparing diuretics

A

Collecting duct

42
Q

Potassium sparing diuretics includes

A

1) Epithelial sodium channel blockers
2) Aldosterone Antagonist

43
Q

Examples of epithelial Sodium channel blockers

A

Decreases Na+ and increased K+ and H+
Amiloride
Triamterene

44
Q

Examples of Aldosterone Antagonist

A

Spironolactone
Epleronone

45
Q

Which diuretics retains K+ while losing Na+

A

Potassium sparing diuretics

45
Q

Which diuretics retains K+ while losing Na+

A

Potassium sparing diuretics

46
Q

Aldosterone Antagonist can be used in

A

Conn’s Syndrome
Preferred in Cirrhotic edema
Reverse Cardiac remodeling or LVH

46
Q

Aldosterone Antagonist can be used in

A

Conn’s Syndrome
Preferred in Cirrhotic edema
Reverse Cardiac remodeling or LVH

47
Q

Side effect of Spironolactone

A

Gynaecomastia

48
Q

Step 3 approach used when

A

Attacks more than 4-5 times a week or once a night per week
Low dose ICS + Formoterol

Maintainer reliever therapy (MART)
Low dose ICS + LABA daily

48
Q

Step 3 approach used when

A

Attacks more than 4-5 times a week or once a night per week
Low dose ICS + Formoterol

Maintainer reliever therapy (MART)
Low dose ICS + LABA daily

49
Q

Step 3 approach used when

A

Attacks more than 4-5 times a week or once a night per week
Low dose ICS + Formoterol

Maintainer reliever therapy (MART)
Low dose ICS + LABA daily