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Nephrology > Diuretics > Flashcards

Diuretics Flashcards

1
Q

which medication is a carbonic anhydrase inhibitor?

A

acetazolamide

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2
Q

which medications are loop diuretics?

A

Furosemide
bumetanide

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3
Q

which medications are thiazide diuretics?

A
  • hydrochlorothiazide
  • metolazone
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4
Q

which medications are potassium sparing diuretics?

A

Spironolactone
triamterene

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5
Q

medications that help the body get rid of sodium and water

  • this decrease in fluid volume can improve your health (lower blood pressure, improve cardiovascular funtion, etc)
A

Diuretics

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6
Q
  • appears to be dose dependent
  • absorption is erratic with daily doses > 10mg/kg
  • has a half life of about 2.5 to 6 hours
  • excreted 70-100% as unchanged drug in the urine
A

Acetazolamide

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7
Q

what are uses of acetazolamide?

A
  • altitude sickness
  • metabolic alkalosis
  • removing acidic drugs
  • cerebral edema
  • glaucoma
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8
Q

what are contraindications and adverse drug effects of acetazolamide?

A

contraindications of acetozolamide

  • history of anaphylactic reactions to sufonamides
  • severe renal/ hepatic dysfunction

Adverse drug effects:

  • dizziness
  • polyuria
  • confusion, tachypnea, tachycardia
  • nausea/vomiting
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9
Q

MOA: Blockade of NA+, K+, 2Cl- transporter in ascending limb of the loop of henle (more sodium Na+ in filtrate, more total volume removed in urine)

A

Loop diuretics

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10
Q

uses of loop diuretics? contraindications?

A

Uses (either IV or PO)

  • CHF
  • Nephrotic syndrome/ cirrhosis
  • edema
  • hypertension
  • hyperkalemia/hypercalcemia treatment

Contraindications

  • history of anaphylactic reactions to sulfonamides
  • kidney failure
  • pregnancy

Furosemide IV:PO conversion 1:2; bumetanide 40x more potent

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11
Q

adverse drug effects of loop diuretics?

A
  • Depletion of Na+, Cl-, Mg+, and especially K+ (hypokalemia)
  • ototoxicity (not generally permeant)
  • furosemide should not exceed 4mg/min given iV
  • exacerbation of gout/ hyperuricemia
  • allergic interstitial nephritis
  • hyperglycemia
  • dyslipidemia

DI: NSAIDs, aminoglycosides, digoxin/QT prolonging drugs

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12
Q

MOA: inhibition of Na+/Cl- cotransporter (aka symporter)

A

Thiazide diuretics

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13
Q

uses and adverse drug effects of thiazide diuretics?

A

Uses

  • edema/ fluid retention
  • CHF
  • hypertension

Adverse drug effects

  • Hypokalemia
  • hyperuricemia
  • impotence
  • glucose intolerance
  • hypercholesterolemia

usually ineffective in CrCl < 30 unless used with loop diuretic (except metolazone due to its greater potency)

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14
Q

drug interactions and contraindications of thiazide diuretics?

A

Drug interactions

  • first dose hypotension when ACE-I added
  • NSAIDs
  • lithium
  • digoxin

Contraindications

  • history of anyphylactic reactions to sulfonamides
  • anuria
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15
Q
  • blockade of aldosterone receptors in distal tube/collecting duct
  • only group today that doesn’t act through tubular secretion
A

spironolactone

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16
Q
  • blockade of sodium channel in distal tubule
  • creates depolarization of luminal side of cell, results in potassium secretion into tubular lumen
A

Triamterene

17
Q

uses and contraindications of potassium sparing diuretics?

A

uses/routes (PO)

  • CHF: sprionolactone
  • cirrhosis: sprionolactone
  • primary aldosteronism: sprionolactone
  • hypertension: Either

Contraindications

  • hyperkalemia
  • renal/ hepatic failure
18
Q

adverse effects of potassium sparing diuretics?

A

All

  • hyperkalemia
  • metabolic acidosis
  • dizziness

Trimaterene

  • flatulence
  • rash
  • nephrolithiasis

Spironolactone

  • steroid side effects
  • gynecomastia
19
Q

drug interactions of potassium sparing diuretics?

A
  • ACE-I, potassium supplements
  • NSAIDs
  • hyperkalemia
20
Q

consequences of hypokalemia?

A
  • can worsen hepatic encephalopathy in liver dysfunction
  • in patients with cardiac history, increased risk of arrhythmias even with mild hypokalemia
  • hypertension
  • muscle cramps, myalgia, weakness

Management
K+ = 3.5-4mEq - Diet
K+= 3-3.5mEq- initiate replacement in high risk pts
K+ < 3 mEQ: Replacement (alternative: add potassium sparing diuretic)

21
Q
  • alternative loop diuretic
  • can be used in patient with severe allergies to other loop diuretics
  • more expensive and more side effects including ototoxicity
A

Ethacrynic Acid

Nephrology (12 decks)

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