Diuretics Flashcards
Carbonic Anhydrase Inhibitor
Acetazolamide
Loop Diuretics
Furosemide (classic) Bumetamide (more bioavailable) Ethycrinic acid (no sulfa moiety) Torsemide (new and long acting, \$\$$)
Thiazides
Hydrochorothiazide
Chlorthalidone
Other diuretics to know
Triamterine
Amiloride
Spironolactone
Eplerone (new, better tolerated, $$$)
When do you use acetazolamide?
- Edema with metabolic alkalosis
- Post hypercapnic alkalosis
- Glaucoma
- Pseudotumor cerebri
When do you use loop diuretics?
Edema
CHF
(can used for HTN, but need low Na diet or frequent dosing)
also:
Hyperkalemia
Hypercalcemia (temporizing tx)
When do you use thiazides?
- Good adjunct for HTN b/c long acting and mild
- Use in conjunction with loop diuretics to increase diuresis
- Decrease hypercalciuria (stones)
- Induce mild volume depletion and promote proximal reabsorption and limit losses in DI
When do you use Triamterine or amiloride?
Decrease potassium loss from other diuretics
When do you use Spironolactone or Eplerone?
- Management of refractory edema in CHF and cirrhosis
- Decrease potassium loss from other diuretics
Side effects of Acetazolamide
Bicarbonate wasting leads to METABOLIC ACIDOSIS
Side effects of loop diuretics
Volume depletion
HYPOKALEMIA
METABOLIC ALKALOSIS
Side effects of thiazides
Volume depletion
HYPOKALEMIA (from distal Na delivery, not direct losses)
METALBOLIC ALKALOSIS
Hypercalcemia
Hyponatremia (limits ability to make maximally dilute urine)
Side effects of triamterine or amiloride
Hyperkalemia
Side effects of spironolactone or eplerone
Hyperkalemia
Caution for using acetazolamide
Modest net diuresis
Not useful for edematous states b/c of many opportunities to reclaim Na
