Diuretics Flashcards
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
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!
which med has the C/I of h.o anaphylaxis to sulfonamides, severe renal/hepatic dysfunction
acetazolamide
which medication has drug interxns of amphetamines, lithium, salicylates
acetazolamide
- 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
spironolactone
3 shared ADR of the two K+ sparing diuretics
hyperkalemia
metabolic acidosis
dizziness
3 drug interactions & 2 C/I of K+ sparing diuretics
- Interactions: ACE-i, K+ supplements, NSAIDs
- C/I: hyperkalemia, acute renal/hepatic failure
- 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
triamterene (dyrenium)
can be used in patients w/ severe allergies to other loop diuretics but is more $$ and has more SE including otoxicity
ethacrynic acid
- 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.
loop diuretics– furosemide & bumetanide
how is furosemide converted from IV to PO
IV:PO is 1:2
- 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
thiazide diuretics– HCTZ & metolazone
high T wave on ECG..
K+ of 7
prolonged P-R
high T wave
depressed S-T segment
K+ of 8
auricular standstill
Intraventricular block
K+ of 9
v fib on ECG
K+ of 10