Diuretics Flashcards
What type of diuretics do we have?
- Loop diuretics
- Thiazide diuretics
- Potassium sparring diuretics(Aldosterone in/dependent)
Furesemide
- MOA
- Site
- DI
- Admin
- Therapeutic index
- Blocks the reabsorption Na+, K+ and Cl-
Below that it blocks the reabsorption of Mg+ and Ca2+ - In the ascending loop of Henle
- NSAIDs: Inhibit the natriuretic response to diuretics and increase the risk of NSAID-associated renal adverse effects
- IV or Oral
- -Rt/Lt-sided heart failure
-Congestive heart failure
-Acute pulmonary oedema
-Hypertension
-Hypercalcaemia
Furosemide ADR
- Hypokalaemia
- Hyponatraemia
- Hypomagnesia
- Hyperuricaemia
- Hyperglycaemia
- Alkalosis
- Ototoixic DI
- Hypotension
Furosemide antidote for hypokalemia?
Potassium supplements
NOT Potassium sparring diuretics
Furosemide and the treatment of cancer-induced ailments?
Furosemide is used in the treatment of cancer-induced hypercalcaemia
Furosemide
- Potency
- Ceiling
- OOA
1.Highly potent
2. High ceiling
3. Rapid acting
Furosemide usage with thiazide diuretics
Used with thiazide diuretics
Thiazide diuretics drugs?
Hydrochlorothiazide
Indapamide
Thiazide diuretics uses?
- Hypertension
- Mild heart failure
- Diabetes insipious(paradoxical effect)
Thiazide diuretics:
- Site
2.MOA - S/E
- Ceiling
- Type of therapy
- Distal convoluted tubules
- Blocks reabsorption Sodium channels in the distal convoluted tubule
- Hypokalaemia
- Hyperuricaemia
- Hyperglycaemia
-Increased skin cancer(melanoma)
-CNS Disturbances - Low ceiling
- Monotherapy
Thiazide diuretic effects on blood
Little effect on blood volume
Thiazide antidote for hypokalemia
Potassium sparring diuretics
Thiazide diuretic effect on collecting duct
Even though thiazide diuretic block the reabsorption of sodium in the distal convutuble , at the collecting duct, the Na+/K pump will be activated and reabsorp Na+ and excretes K+(thus the hypokalemia)
Potassium-sparring diuretics drugs?
- Amiloride
- Triamterene
Potassium-sparring diuretics MOA
Blocks the Na+/K+ exchange in the collecting duct
Thiazide diuretics relationship with aldosterone
independent of aldosterone
Potassium-sparring diuretics DI?
ACE-1
Which thiazide diuretic is used with Potassium-sparring diuretics?
Hydrochlorothiazde(HCTZ) to prevent hyokalamia
Spirinolactone MOA?
Aldosterone antagonist
Blocks the Na+/K+ exchange in the collecting duct
Spironolactone indications and combined drugs?
Hypertension(with HCTZ)
Heart failure(with Ace-Ibhibitors)
Spirinolactone side effects?
-Hyperkalaemia
-Gynaecomastia
-Acidosis
Describe the RAAS system
- Angiotensinogen is converted into angiotensin I by renin
- Angiotensin I is converted into Angiotensin II by ACE
- Angiotensin II binds to AT1 receptor
- The are two consequences of this:
- Increased Aldosterone and increased sodium and water retention
-Vasoconstriction and an increase in TPR
What are the RAAS pharmacology drugs and where do they act?
- ACE inhibitors
Ramipril
Enalapril
Captopril - ARBS
(Prevent binding of ANGII to AT-1 receptor)
Lorsartan
Valsartan