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Pharm Test 4 > Diuretics > Flashcards

Diuretics Flashcards

1
Q

Carbonic Anhydrase Inhibitors- Examples

A

Acetazolamide
dorzolamide
methazolamide
dichlorphenamide

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2
Q

Carbonic Anhydrase Inhibitors- Mech of Action

A

inhibit carbonic anhydrase in luminal membrane of PROXIMAL TUBULE, reducing proximal HCO3 reabsorption

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3
Q

Carbonic Anhydrase Inhibitors- Main Indications

A
  • reduce intraocular pressure in glaucoma
  • lower [HCO3]p in “mountain sickness”
  • raise urine pH in cystinuria
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4
Q

Carbonic Anhydrase Inhibitors- Other Uses

A
  • hypokalemic periodic paralysis (may require dietary potassium supplements to prevent potassium wasting)
  • adjunctive therapy in epilepsy
  • solid hypoxic tumors?
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5
Q

Carbonic Anhydrase Inhibitors- Side Effects

A
  • metabolic acidosis (due to HCO3 depletion w/ prolonged treatment)
  • hypokalemia (acute effect)
  • drowsiness
  • fatigue
  • CNS depression
  • paresthesia
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6
Q

Osmotic Diuretics (Mannitol)- Mech of Action

A
  • act primarily on the proximal tubule to reduce the reabsorption of water and solutes, including NaCl
  • are freely filterable, non-reabsorbable osmotic agents
  • ex. MANNITOL, glycerol, urea
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7
Q

Osmotic Diuretics (Mannitol)- Main Indications

A
  • treat or prevent Acute Renal Failure (ARF)
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8
Q

Osmotic Diuretics (Mannitol)- Other Uses

A
  • reduce intra-cranial or intra-ocular pressure

- enhance urinary excretion of chemical toxins

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9
Q

Osmotic Diuretics (Mannitol)- Side Effects

A
  • acute expansion of ECF volume and increased risk of pulmonary edema, hyponatremia (w/ impaired renal function)
  • nausea and vomiting
  • headache
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10
Q

Loop Diuretics- Examples

A

Furosemide
bumetanide
ttorsemide
ethacrynic acid

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11
Q

Loop Diuretics- Mech of Action

A
  • inhibit the Na/K/2Cl cotransport system in the thick ascending limb of Henle’s loop (ALH)
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12
Q

Loop Diuretics- Main Indications

A
  • acute pulmonary edema
  • hypertension
  • congestive heart failure (CHF), in the presence of renal insufficiency or for immediate effect
  • ARF, CRF, ascites, and nephrotic syndrome
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13
Q

Loop Diuretics- Other Uses

A

hypercalcEMIA

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14
Q

Loop Diuretics- Side Effects

A
  • HYPOVOLEMIA
  • hypokalemia
  • hypomagnesemia
  • hyponatremia
  • hyperuricemia (WHICH CAN CAUSE GOUT)
  • metabolic alkalosis
  • ototoxicity and diarrhea (mainly w/ ethacrynic acid)
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15
Q

Thiazide- Examples

A 
chlorothiazide
hydrocholorthiazide
chlorthalidone
metolazone
indapamide
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16
Q

Thiazide- Mech of Action

A
  • inhibit NaCl cotransport in early distal convoluted tubule (DCT)
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17
Q

Thiazide- Main Indications

A
  • hypertension
  • edema due to CHF, hepatic cirrhosis, renal disease
  • idiopathic hypercalciURIA (renal calculi)
18
Q

Thiazide- Other Uses

A
  • Nephrogenic Diabetes Insipidus (prevent further urine dilution from taking place in the DCT)
19
Q

Thiazide- Side Effects

A

Hypokalemia; hyponatremia; hypovolemia;

Hyperuricemia due to enhanced urate reabsorption and hypercalcemia due to enhanced Ca reabsorption

Metabolic alkalosis
Hyperglycemia (insulin resistance); hyperlipidemia.
Hypersensitivity (fever, rash, purpura, anaphylaxis); interstitial nephritis

20
Q

K-Sparing Diuretics- Examples

A

Spironolactone
eplerenone
amiloride
triamterene

21
Q

K-Sparing Diuretics- Spironolactone & Eplerenone Mech of Action

A
  • competitively block the actions of aldosterone on the collecting tubules
22
Q

K-Sparing Diuretics- Amiloride & Triamterene Mech of Action

A
  • reduce Na entry across the luminal membrane of the principal cells of the collecting tubules
23
Q

K-Sparing Diuretics- Main Indications

A
  • Chronic liver disease: to treat secondary hyper-aldosteronism due to hepatic cirrhosis complicated by ascites (spironolactone, eplerenone)
  • to prevent the hypokalemic effects of other diuretics
24
Q

K-Sparing Diuretics- Other Uses

A
  • Primary hyperaldosteronism (Conn’s syndrome; spironolactone, eplerenone)
25
Q

K-Sparing Diuretics- Spironolactone Side Effects

A 
HYPERKALEMIA
gynecomastia
hirsutism
menstrual irregularities
testicular atrophy (w/ prolonged use)
26
Q

K-Sparing Diuretics- Amiloride Side Effects

A

HYPERKALEMIA

glucose intolerance in diabetic pts.

27
Q

K-Sparing Diuretics- Triamterene Side Effects

A

HYPERKALEMIA

megaloblastic anemia in pts w/ liver cirrhosis

28
Q

ADH Antagonists- Examples

A 
doxycycline
lithium
tolvaptan
conivaptan
mozavaptan
29
Q

ADH Antagonists- Mech of Action

A

SIADH

Euvolemic or hypervolemic hyponatremia

30
Q

ADH Antagonists- Other Uses

A

Congestive Heart Failure (CHF)

31
Q

ADH Antagonists- Lithium, Doxycycline Side Effects

A

nephrotoxic

32
Q

ADH Antagonists-Tolvaptan, Conivaptan, Mozavaptan Side Effects

A 
hypernatremia
thirst
dry mouth
hypotension
dizziness
33
Q

ACE Inhibitors Interactions

A

K-sparing diuretics

  • increased hyperkalemia–>cardiac arrhythmias (monitor serum K closely)
34
Q

Aminoglycosides Interactions

A

Loop diuretics

  • ototoxicity and nephrotoxicity (monitor hearing and serum creatinine closely)
35
Q

Anticoagulants Interactions

A

Thiazide & Loop diuretics

  • increased anti-coagulant activity w/ loop diuretics; decreased anti-coagulant activity w/ thiazide diuretics
36
Q

B-blockers Interactions

A

Thiazide & Loop diuretics

  • hyperglycemia, hyperlipidemia, hyperuricemia
  • increased plasma levels of propranolol
37
Q

Carbamazepine or Chlorpropamide Interactions

A

Thiazide diuretics

  • increased risk of hypnatremia (monitor Na)
38
Q

Digoxin Interactions

A

Thiazide & Loop diuretics

  • hypokalemia–>increased digoxin binding & toxicity (monitor K and cardiac function)
39
Q

NSAIDs Interactions

A

Thiazide & Loop Diuretics
K-sparing diuretics

  • reduced diuretic effect, increased risk of salicylate toxicity w/ high doses of salicylates (thiazide & loop)
  • increased risk of hyperkalemia w/ K sparing diuretics
40
Q

Quinidine Interactions

A

Thiazide & Loop diuretics

  • polymorphic ventricular tachycardia (torsade de pointes)
41
Q

Sulfonylureas Interactions

A

Loop diuretics

  • hyperglycemia
42
Q

Steroids Interactions

A

Thiazide & Loop diuretics

  • increased risk of hypokalemia (monitor serum K closely)

Pharm Test 4 (6 decks)

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