Diuretics Flashcards

1
Q

medication? is it a good diuretc?

  • causes net loss of bicarb & sodium; reversible inhibition of carbonic anhydrase at the PCT
  • used for altitude sickness/functional metabolic alkalosis, removing acidic drugs, cerebral edema and glaucoma
  • SE: dizziness, polyuria, confusion, tachypnea, tachycardia, N/V
A

Acetazolamide (diamox)
- not really used in diuresis & HTN because it acts on PCT and after that there is so many opportunities after that for sodium reabsorption especially at the loop of henle!

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2
Q

which med has the C/I of h.o anaphylaxis to sulfonamides, severe renal/hepatic dysfunction

A

acetazolamide

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3
Q

which medication has drug interxns of amphetamines, lithium, salicylates

A

acetazolamide

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4
Q
  • acts in late DCT and collecting duct through gene transcription to reduce # of transporters; only group that doesn’t act thru tubular secretion
  • Uses: CHF, HTN, cirrhosis,primary aldosteronism
  • specific ADR: steroid SE, gynecomastia
A

spironolactone

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5
Q

3 shared ADR of the two K+ sparing diuretics

A

hyperkalemia
metabolic acidosis
dizziness

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6
Q

3 drug interactions & 2 C/I of K+ sparing diuretics

A
  • Interactions: ACE-i, K+ supplements, NSAIDs
  • C/I: hyperkalemia, acute renal/hepatic failure
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7
Q
  • blocks Na channel in late DCT; creates depolarization of luminal side of cell, results in K+ secretion into tubular lumen
  • Uses: HTN
  • specific ADR: flatulence, rash, nephrolithiasis
A

triamterene (dyrenium)

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8
Q

can be used in patients w/ severe allergies to other loop diuretics but is more $$ and has more SE including otoxicity

A

ethacrynic acid

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9
Q
  • MOA: blocks Na, K, Cl transporters in ascending loop of henle→ More Na+ in filtrate, more total volume removed in urine!!
  • Uses: CHF, nephrotic syndrome/cirrhosis, edema, HTN, hyperkalemia/hypercalcemia
  • C/I: h.o sulfonamide anaphylaxis, kidney failure (soft C/I), pregnancy
  • Se: hypo-K+,Na,Cl,Mg, ototoxicity, gout exacerbation, allergic interstitial nephritis, hyperglycemia, dyslipidemia, orthostatic hypotension
  • drug interxns: NSAID, aminoglycosides, digoxin/QT prolong.
A

loop diuretics– furosemide & bumetanide

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10
Q

how is furosemide converted from IV to PO

A

IV:PO is 1:2

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11
Q
  • MOA: inhibition of Na/Cl cotransporter (aka symporter) at the DCT→ More Na+ in filtrate, more total volume removed in urine!!
  • Uses: edema/fluid retention, CHF, HTN
  • ADR: hypokalemia, hyperuricemia, impotence, glucose intolerance, hypercholesterolemia
  • drug interxns: ACE-i (first dose hypotension if added), NSAIDs, lithium, digoxin
  • C/I: h.o sulfonamides anaphylaxis, anuria
A

thiazide diuretics– HCTZ & metolazone

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12
Q

high T wave on ECG..

A

K+ of 7

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13
Q

prolonged P-R
high T wave
depressed S-T segment

A

K+ of 8

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14
Q

auricular standstill
Intraventricular block

A

K+ of 9

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15
Q

v fib on ECG

A

K+ of 10

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16
Q

low T wave or S-T segment
high U wave

A

K+ 2.5

17
Q

low T wave only

A

K+ 3.5

18
Q

what condition is this? how is it treated?

  • Worsen hepatic encephalopathy
  • Increased risk of arrhythmias
  • HTN, muscle cramps, myalgias, weakness
A

hypokalemia
if under 3– replacement
if above 3.5– diet changes

19
Q

which class of medication from this lecture does NOT have C/I of sulfonamide anaphylaxis

A

thiazide diuretics

20
Q

which class of meds in this lecture is C/I in pregnancy

A

loop diuretics

21
Q

which class does NOT interact with NSAIDs?

A

carbonic anhydrase inhibitors– acetazolamide