Diuretics Flashcards
What are the loop diuretics
Furosemide
Toresemide
What are the thiazides
Chlorthalidone
Hydrochlorothiazide
Metolazone
What are the K sparing diuretics
Spironolactone
Eplerenone
Amiloride
Triamterene
What is the CAH inhibitor
Acetazolamide
What is the osmotic diuretic
Mannitol
What is the ADH antagonist and acts on V1 and 2
Conivaptan
What do loop diuretics act on
NKCC2
What do thiazides act on
NCCT
What acts as an aldosterone antagonist
Spironolactone
Eplerenone
What acts on ENaC
Amiloride
Triamterene
DOC for acute pulm edema with HF
Loop diuretics
HTN in DI
Thiazides
Main AE for Loop
Ototoxicity
Hypokalemia
Main AE for aldosterone agonists
Irregular menstrual cycle
gynecomastia
Impotence
Main AE for Acetazolamide
Metabolic acidosis
Main AE for Mannitol
Dehydration
What are the most effective diuretic
Loop
Which diuretic class decrease PVR and BP even after volume recovery
Thiazides
What are the sulfa derivatives
Thiazides
What is the NKCC2
Na/Cl/K cotransporter
Where do loops act
LOH duh
What increases PG synthesis via COX 2
Loop diuretics
Under what conditions can you give loop diuretic
Hypercalcemia
Hyperkalemia
What is the urine composition in a pt on loop diuretics
Increased Ca, Na, K, Mg, volume
What is the urine composition in a pt on thiazides
Increased Na, K, Cl, Mg, volume
Decreased Ca
AE of Loops
Hyperuricemia (since renal clearance is affected)
Acute hypovolemia
Hypomagnesemia
Allergies (sulfa)
What is NCCT
NA/Cl cotransporter
Where is NCCT
DCT
Do thiazides have a ceiling effect
Yes
When can you give a thiazide
HTN
Mild HF
Hypercalcemia
What are the less obvious AE for thiazides
Hyperuricemia
Hyperglycemia
Hyperlipidemia
Where do aldosterone antagonists act
Collecting tubule
How are aldosterone antagonists administered
Orally but with other diuretics
When are aldosterone antagonists given
Primary hyperaldosteronism
Edema
What is the urine composition in a pt on aldosterone antagonists
Increased Na
Decreased K
Which K sparing induce P450
Spironolactone
Epleronone
AE in aldosterone antagonists
GI upset, peptic ulcers
Hyperkalemia
Nausea/lethargy
Mental confusion
What is ENaC
Na channel
Where is ENaC
Collecting duct
AE of ENaC inhibitors
Same as spironolactone
Leg cramps
Increase BUN and uric acid
What acts in the PT
Acetazolamide
How does Acetazolamide work
Prevent H formation for Na reabsorption
What is Acetazolamide used for
Glaucoma (reduce aqueous humor)
Mountain sickness prophylaxis
Epilepsy
Urine composition in pt on Acetazolamide
Increased Na, K, bicarb
How does Acetazolamide affect urine pH
Increases
Contraindication for Acetazolamide use
Hepatic cirrhosis
Which diuretic does not affect Na excretion
Mannitol
When is Mannitol used
Increased ICP
Acute renal failure (shock)
Drug toxicity
Trauma (maintain urine)
Which diuretics are IV only
Mannitol
Conivaptan
AE of Mannitol
Renal stones
K depletion
Where does Conivaptan act
Collecting tubule
What is Conivaptan used for
SIADH
Hyponatremia
What is the urine composition of someone on Conivaptan
Dilute urine
Decreased Na
AE for Conivaptan
Nephrogenic DI
Renal failure