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Urinary > Diuretics > Flashcards

Diuretics Flashcards

1
Q

What are diuretics?

A

Drugs which act on the kidney to increase urine production + eliminate water from the body

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2
Q

What are the 5 main classes of diuretics?

A
  • loops diuretics
  • potassium sparing diuretics
  • thiazide + thiazide-like diuretics
  • carbonic anhydrase inhibitors
  • osmotic diuretics
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3
Q

Where do carbonic anhydrase inhibitors work?

A

PCT

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4
Q

Where do osmotic diuretics work?

A

Across whole nephron but mainly PCT

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5
Q

Where do loop diuretics work?

A

Loop of Henle (ascending limb)

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6
Q

Where do potassium sparing diuretics work?

A

Distal DCT + collecting duct

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7
Q

Outline how carbonic anhydrase inhibitors work

A
  • PCT
  • inhibit carbonic anhydrase
    H2CO3 => CO2 + H2O is prevented
  • less H+ inside cell to swap with Na+ in nephron
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8
Q

Outline how osmotic diuretics work

A
  • PCT
  • increases osmotic pressure within kidney
  • inhibits reabsorption of water
  • increases water excretion with little effect on Na+
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9
Q

Example of osmotic diuretics

A

Mannitol

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10
Q

Uses of osmotic diuretics

A
  • acute renal failure due to shock or trauma
  • acute drug poisoning
  • decrease intracranial + intraocular pressure before ophthalmic or brain procedures
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11
Q

Side effects of osmotic diuretics

A
  • hyponatremia > headaches, nausea, vomiting
  • extracellular volume expansion > complicates heart failure + pulmonary oedema
  • contraindicated in chronic heart failure
  • excessive use > dehydration + hypernatremia ??
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12
Q

How do loop diuretics work?

A
  • loop of Henle
  • blocks NKCC cotransporter
  • build up of Na+, K+ and Cl-
  • given orally or via IV
  • increase urine volume
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13
Q

What is the most potent diuretic?

A

Loop diuretics

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14
Q

Uses of loop diuretics

A

Emergency situations:
- severe oedema associated with congestive heart failure + nephrotic syndrome
- oliguric AKI
- hypercalcaemia
- hyperkalaemia
- acute pulmonary oedema
- toxicity of Br, F + I

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15
Q

Two example of loop diuretics

A

bumetanide
furosemide

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16
Q

Side effects of loop diuretics

A
  • hypovolaemia
  • hyponatremia
  • hypokalaemia
  • hypomagnesaemia
  • metabolic alkalosis
  • postural hypotension
17
Q

How can loop diuretics cause metabolic alkalosis?

A

Increases urine volume > decreases blood volume > increased bicarbonate conc. > increased pH

18
Q

What is needed when using potassium sparing diuretics to avoid hypokalaemia?

A

Dietary potassium supplements

19
Q

Where do thiazide + thiazide like diuretics work?

A

DCT

20
Q

Two examples of thiazide + thiazide like diuretics

A

bendroflumethiazide
indapamide

21
Q

Uses of thiazide + thiazide like diuretics

A

For treatment of:
- essential hypertension
- mild heart failure
- calcium nephrolithiasis due to hypercalciuria
- osteoporosis
- nephrogenic diabetes insipidus polyuria

22
Q

How can thiazide + thiazide like diuretics cause hypercalcemia?

A
  • NaCL transporter blocked
  • less Na+ in cell
  • more drawn in from blood via NaCa cotransporter in basolateral membrane
  • more Ca2+ leaves + is reabsorbed
23
Q

How do thiazide + thiazide like diuretics work?

A

DCT
- block Na+Cl- transporter

24
Q

Example of potassium sparing diuretic

A

amiloride

25
Q

Example of aldosterone antagonist

A

spironolactone

26
Q

Uses of potassium sparing diuretic + aldosterone antagonists

A
  • secondary hyperaldosteronism
  • hepatic cirrhosis
  • nephrotic syndrome
  • hypertension treatment
27
Q

How do potassium sparing diuretics + aldosterone antagonists work in the CD + DCT

A
  • PSD: block ENAC channels
  • AA: decrease aldosterone > decreased ENAC + ROMK
28
Q

What type of drug is mannitol?

A

Osmotic diuretic

29
Q

What type of drug is bumetanide?

A

Loop diuretic

30
Q

What type of drug is furosemide?

A

Loop diuretic

31
Q

What type of drug is bendroflumethiazide?

A

Thiazide + thiazide like diuretic

32
Q

What type of drug is indapamide?

A

Thiazide + thiazide like diuretic

33
Q

What type of drug is amiloride?

A

Potassium sparing diuretic

34
Q

What type of drug is spironolactone?

A

Aldosterone antagonist

35
Q

What is diuresis?

A

The excretion of water in the urine

36
Q

What is natriuresis?

A

Excretion of sodium in the urine

37
Q

Issues with osmotic diuretics administer via IV

A

Water drawn towards it in blood vessels on route to kidney:
- expands extracellular fluid volume
- decreases blood viscosity
- Inhbits renin release

Urinary (24 decks)

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