Diuretics

Question 1

Name the 3 carbonic anyhydrase inhibitiors

Answer 1

acetazolamide, methazolamide and dichlorphenamide

Question 2

Carbonic anhydrase inhibitors MOA

Answer 2

Inhibits Na/H antiporter but preventing bicarb reabsorption so no H+ is present to drive Na+ in up its gradient.

Question 3

What do carbonic anhydrase inhbitors treat?

Answer 3

Glaucoma and mountain sickness (FeNa = 5%)

Question 4

What are the 6 common side effects of carbonic anhydrase inhibitors?

Answer 4

1. Increased K+ excretion
2. Metabolic acidosis
3. Hepatic enchealopathy
4. Bone marrow depression
5. Skin toxicity
6. Allergic reactions

Question 5

Who can’t you use carbonic anhydrase inhibitors in?

Answer 5

Cirrhotic patients

Question 6

Name the osmotic diuretics, how must they be given?

Answer 6

manitol, glucose, urea and isorbide given IV

Question 7

How to osmotic diuretics work?

Answer 7

Oppose water and sodium reabsorption in the proximal tubule by increasing the osmolarity of the fluid with a compound that cannot be reabsorbed

Question 8

What is the 1 side effect of osmotic diuretics?

Answer 8

Risk of pulmonary edema

Question 9

What do osmotic diuretics treat?

Answer 9

Help clear high levels of drugs, helps with renal failure in shock and surgery, and glaucoma/increased intracranial pressure

Question 10

Name the 4 loop diuretics.

Answer 10

Furosemide, bumetanide, torsemide, ethacrynic acid

Question 11

What do the loop diuretics act on, where in the kidney do they act and what solute abnormalities result?

Answer 11

Act on the Na/K/2Cl transporter in the thick ascending limb of the loop of henle, inhibiting the Cl portion

Question 12

What 4 conditions do the loop diuretics treat?

Answer 12

1. Crisis edema (CHF/cirrhosis/pulmonary)
2. Hypercalcemia
3. Drug toxicity/OD
4. Severe hypertension in CHF and cirrhosis

Question 13

Name the 4 most serious complications of the loop diuretics.

Answer 13

1. Hypo: kalemia, calcemia and magnesemia = arrhythmia
2. Contraction alkalosis
3. Increased BUN and creatinine
4. Ototoxicity

Question 14

Name the 7 other potential side effects of loop diuretics shared with thiazide diuretics

Answer 14

1. Hyper: glycemia, lipidemia, uricemia
2. Gout
3. Hyponatremia
4. Nephrocalcinosis
5. Erectile dysfunction
6. Drug interactions
7. Photosensitivity

Question 15

Name the 6 thiazide diuretics

Answer 15

Chlorothiazide, hydrochlorothiazide, chlorthalidone, quinethazone, metolazone, indapamide

Question 16

How and where do the thiazide diuretics act?

Answer 16

They inhibit the Cl- portion of the Na/Cl co transporter in the early distal tubule causing decreased Na reabsorption and increased Ca reabsorption

Question 17

What do thiazide diuretics treat?

Answer 17

1. Hypertension (via intravascular contraction)
2. Chronic edema
3. Idiopathic hypercalciuria (stones)
4. Nephrogenic diabetes insipidus

Question 18

What additional conditions does chlorthalidone treat?

Answer 18

Stroke risk and CHF events

Question 19

What major side effects do thiazides cause?

Answer 19

Hypokalemia, hypercalcemia, contraction alkalosis, increased BUN and creatinine