Diuretics Flashcards

1
Q

Diuresis

A

Increased urine flow rate

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2
Q

What are the major osmolytes being reabsorbed by the kidney?

A

Sodium Chloride (NaCl)
Bicarbonate (HCO3-)
Calcium (Ca2+)

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3
Q

What are the major osmolytes secreted by the kidney?

A

Hydrogen (H+)
Potassium (K+)

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4
Q

Where is most of the NaCl and water reabsorbed?

A

Proximal tubule: 65-75%
Loop of Henle (20-25)
Distal nephron (5-7)

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5
Q

Indication for diuretic use

A

-Reduce extracellular fluid volume (pulmonary congestions, ascites, CHF)
-Oliguric renal failure
-Hypertension (Exercise Induced Pulmonary Hemorrhage)
-Promote urinary excretion of selected agents/electrolytes

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6
Q

Which class of diuretics is most commonly used?

A

Loop diuretics

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7
Q

Osmotic Diuretics Mechanism

A

Inhibits water reabsorption in the proximal tubule and loop by increasing the osmotic gradient in the lumen

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8
Q

Mannitol

A

Osmotic Diuretic
-freely filtered at glomerulus
Used to treat oliguric renal failure, cerebral edema, acute glaucoma

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9
Q

Carbonic Anhydrase Inhibitors Mechanism

A

Increase loss of bicarb and tendency to increase urine pH
(b/c bicarb is basic)

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10
Q

Acetazolamide

A

Carbonic Anhydrase inhibitor
Weak diuretic effect
Alkalinizing effect on urine -> systemic acidosis
May cause hypokalemia
Used to treat metabolic alkalosis, glaucoma, altitude sicknes

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11
Q

Loop Diuretics

A

Inhibits NaCl reabsorption in the thick ascending limb of the loop of Henle
-Most effective diuretic
-Most commonly used

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12
Q

Furosemide

A

Lasix, Salix
Loop diuretic
Most effective diuretic and most widely used in vet med
May cause hypokalemia and increase urinary loss of Ca2+
Used to treat oliguric renal failure, CHF, acute pulmonary hypertension, and EIPH

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13
Q

Oliguric

A

Low urine output

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14
Q

Effects of furosemide on racehorse performance

A

Used for Exercise Induced Pulmonary Hemorrhage
-fluid loss = decr. body weight
-reduced BP in pulmonary circulation
-Bronchodilation
-Diuretic effect can mask the presence of other drugs in the urine

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15
Q

Thiazide Diuretics Mechanism

A

Distal convoluted tubule
Prevent resorption of Na and Cl in the distal tubule by blocking the symporter > Na and Cl retained in the filtrate

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16
Q

Chlorothiazide

A

Thiazide diuretic
Used to treat nephrogenic diabetes insipidus, udder edema in cattle, Ca2+ containing uroliths

17
Q

K+ sparing Diuretics

A

Other diuretics increase Ka+ in distal segments which leads to K+/H+ loss. These help maintain electrolyte balance.
Useful in patients with CHF

18
Q

Spironolactone

A

K+ sparing diuretic
Block activity of aldosterone
Used in combo w/ a loop diuretic to prevent hypokalemia
-Used to treat hormonal acne in women

19
Q

Amiloride

A

Epithelial Sodium channel blocker
Used in combo with loop diuretics
K+ sparing diuretic

20
Q

Digoxin and diuretics

A

Have to be careful b/c diuretics lead to K depletion which in combo with digoxin can increase arrhythmias
(K+ sparing are better)

21
Q

How do the collecting ducts work

A

Secretion of ADH (vasopressin) opens aquaporins and allows water to flow back into the cell, concentrating the urine
Diabetes insipidus results from lack of ADH > severe diuresis

22
Q

Demeclocycline

A

Aquaretic: Antagonize ADH receptors in the kidney
Promotes solute free water clearance
Off target effect of antibiotic