Diuretics

Question 1

3 Classes of Diuretics

Answer 1

Loop Diuretics (Sulfonamide)
Thiazides
K+ sparing diuretics (SEAT - Spironolactone, Triamterene, Amiloride, Eplerenone)

Question 2

Loop diuretics MOA

Answer 2

Inhibit Na/K/Cl transporter in thick ascending Loop of Henle
Increase Mg2+ & Ca2+ excretion
Induce renal prostaglandin synthesis
Furosemide - Increases renal blood flow

Question 3

Loop Diuretics PK

Answer 3

Rapid A, Rapid response when given IV
E by tubular secretion & filtration
E in 2-3h

Question 4

Loop Diuretics ADR

Answer 4

Hypo (K, Mg)
Ototoxicity ( when used with aminoglycoside)
Hyperuricemia

Question 5

Loop Diuretics Uses

Answer 5

Edema
Acute hyperkalemia
Acute renal failure
Anion overdose

Question 6

Thiazides MOA

Answer 6

Inhibit NaCl reabsorption by blocking NaCl transporter
Enhance Ca2+ reabsorption in DCT
Action depends on renal PG synthesis (NSAIDS can interfere)

Question 7

Thiazides ADR

Answer 7

Hypo (K, Na)
Hyperuricemia
Hyperglycemia (hypokalemia reduces release of insulin)
Hyperlipidemia

Question 8

Thiazides Uses

Answer 8

Hypertension
Congestive HF
Nephrogenic Diabetes Insipidus
Nephrolithiasis due to idiopathic hypercalciuria

Question 9

Name of K+ Sparing Diuretics (4 drugs)

Answer 9

Aldosterone receptor inhibitor: Spironolactone, Eplerenone
Na+ channel inhibitor: Amiloride, Triamterene

Question 10

K+ Sparing Diuretics MOA

Answer 10

Decrease Na reabsorption & K secretion

Question 11

K+ Sparing Diuretics PK

Answer 11

Spironolactone - slow onset (days)
Amiloride - renal E unchanged
Triamterene - shorter t1/2, liver M

Question 12

K+ Sparing Diuretics ADR

Answer 12

Hyperkalemia
Metabolic Acidosis
Gynecomastia
Acute renal failure (triamterine + indomethacin - reduces blood supply)
Kidney stones (triamterene)

Question 13

K+ Sparing Diuretics Uses

Answer 13

Diuretic
Hyperaldosteronism

Question 14

Name of loop diuretics

Answer 14

Sulfonamides:
Furosemide