Diuretics Flashcards
Acetazolamide
Carbonic anhydrase inhibitor
Carbonic anhydrase inhibitors
Acetazolamide
Brinzolamide
Dorszolamide
Brinzolamide
Carbonic anhydrase inhibitor
Topical for glaucoma
Dorszolamide
Carbonic anhydrase inhibitor
Topical for glaucoma
Carbonic anhydrase inhibitor
Mechanism of action
Inhibition of the enzyme prevents dehydration of H2CO3 and hydration of CO2 in the proximal convoluted tubule
Inhibition of the enzyme prevents dehydration of H2CO3 and hydration of CO2 in the proximal convoluted tubule
Carbonic anhydrase inhibitor
Mechanism of action
Acetazolamide
Mechanism of action
Inhibition of the enzyme prevents dehydration of H2CO3 and hydration of CO2 in the proximal convoluted tubule
Carbonic anhydrase inhibitor
Effects
- Reduces reabsorbtion of HCO3- , causing self-limited diuresis
- hyperchloremic metabolic acidosis reduces body ph, reduces intraocular pressure
Carbonic anhydrase inhibitor
Clinical applications
Glaucoma, moutain sickness, edema with alkalosis
Glaucoma, moutain sickness, edema with alkalosis
Carbonic anhydrase inhibitor
Clinical applications
Loop diuretics
Furosemide
Bumetanide
Torsemide
Ethacrynic acid
Furosemide
Loop diuretic (sulfonamide)
Bumetanide
Loop diuretic (sulfonamide)
Torsemide
Loop diuretic (sulfonamide)
Ethacrynic acid
Loop diuretic (not sulfonamide)
Furosemide
Mechanism of action
Inhibition of the Na/K/2Cl in the ascending limb of Henle’s loop
Inhibition of the Na/K/2Cl in the ascending limb of Henle’s loop
Furosemide
Mechanism of action
Loop diuretics
Mechanism of action
Inhibition of the Na/K/2Cl in the ascending limb of Henle’s loop
Loop diuretics
Effects
- Marked increase in NaCl excretion
- Some K wasting
- Hypokalemic metabolic alkalosis
- Increased urine Ca and Mg
- Marked increase in NaCl excretion
- Some K wasting
- Hypokalemic metabolic alkalosis
- Increased urine Ca and Mg
Loop diuretics
Effects
Loop diuretics
Clinical applications
-Pulmonary edema.
-Peripheral edema.
-Hypertension.
-Acute hypercalcemia.
-Acute hyperkalemia.
-Renal failure anion overdose (bromide, fluoride,
and iodide.
-Pulmonary edema.
-Peripheral edema.
-Hypertension.
-Acute hypercalcemia.
-Acute hyperkalemia.
-Renal failure anion overdose (bromide, fluoride,
and iodide.
Loop diuretics
Clinical applications
Loop diuretics
Toxicity
Ototoxicity Hypovolemia K wasting Hyperuricemia Hypomagnesemia
Thiazide diuretics
Hydrochlorothiazide Chlorothiazide Bendroflumethiazide Hydroflumethazide Methyclothiazide Indapamide
Hydrochlorothiazide
Thiazide diuretic
Chlorothiazide
Thiazide diuretic
Hydroflumethazide
Thiazide diuretic
Methyclothiazide
Thiazide diuretic
Indapamide
Thiazide diuretic
Thiazide diuretic
Mechanism of action
Inhibition of the Na/Cl transporter in the distal convoluted tubule
Inhibition of the Na/Cl transporter in the distal convoluted tubule
Thiazide diuretic
Mechanism of action
Thiazide diuretic
Effects
Modest increase in NaCl excretion
Some K wasting
Hypokalemic metabolic alkalosis
Decreased urine Ca
Modest increase in NaCl excretion
Some K wasting
Hypokalemic metabolic alkalosis
Decreased urine Ca
Thiazide diuretic
Effects
Thiazide diuretic
Clinical applications
Hypertension
Mild heart failure
Nephrolithiasis
Nephrogenic diabetes insipidus
Hypertension
Mild heart failure
Nephrolithiasis
Nephrogenic diabetes insipidus
Thiazide diuretic
Clinical applications
Thiazide diuretic
Toxicities
Hypokalemic metabolic alkalosis
Hyperuricemia
Hyperglycemia
Hyponatremia
Hypokalemic metabolic alkalosis
Hyperuricemia
Hyperglycemia
Hyponatremia
Thiazide diuretic
Toxicities
Potassium-sparing diuretics
Spironolactone
Eplerenone
Amiloride
Triamterene
Spironolactone
Potassium-sparing diuretic
Eplerenone
Potassium-sparing diuretic
Amiloride
Potassium-sparing diuretic
Triamterene
Potassium-sparing diuretic
Spironolactone
Mechanism of action
Pharmacologic antagonist of aldosteron in collecting tubules
Weak antagonism of androgen receptor
Pharmacologic antagonist of aldosteron in collecting tubules
Weak antagonism of androgen receptor
Spironolactone
Mechanism of action
Eplerenone
Mechanism of action
Pharmacologic antagonist of aldosteron in collecting tubules
Weak antagonism of androgen receptor
Like spironolactone, more selective for aldosterone receptor
Pharmacologic antagonist of aldosteron in collecting tubules
Weak antagonism of androgen receptor
Like spironolactone, more selective for aldosterone receptor
Eplerenone
Mechanism of action
Spironolactone
Effect
Reduces Na retention and K wasting in kidney
Poorly understood antagonism of aldosterone in heart and vessels
Reduces Na retention and K wasting in kidney
Poorly understood antagonism of aldosterone in heart and vessels
Spironolactone
Effect
Spironolactone
Eplereone
Clinical application
Aldosteronism from any cause
Hypokalemia due to other diuretics
Postmyocardial infarction
Aldosteronism from any cause
Hypokalemia due to other diuretics
Postmyocardial infarction
Spironolactone
Eplereone
Clinical application
Spironolactone
Toxicity, interactions
Hyperkalemia
Gynecomastia
Additive interaction with other K-retaining drugs
Hyperkalemia
Gynecomastia
Additive interaction with other K-retaining drugs
Spironolactone
Toxicity, interactions
Eplerenone
Toxicity, interactions
Hyperkalemia
Additive interaction with other K-retaining drugs
Hyperkalemia
Additive interaction with other K-retaining drugs
Eplerenone
Toxicity, interactions
Amiloride
Mechanism of action
Blocks epithelial sodium channels in collecting tubules
Blocks epithelial sodium channels in collecting tubules
Amiloride
Mechanism of action
Amiloride
Effects
Reduces Na retention and K wasting
Increases lithium clearance
Reduces Na retention and K wasting
Increases lithium clearance
Amiloride
Effects
Amiloride
Clinical applications
Hypokalemia from other diuretics
Reduces lithium induced polyuria
Hypokalemia from other diuretics
Reduces lithium induced polyuria
Amiloride
Clinical applications
Amiloride
Toxicity
Hyperkalemic metabolic acidosis
Hyperkalemic metabolic acidosis
Amiloride
Toxicity
Triamterene
Mechanism like Amiloride, much less potent, more toxic.
Mechanism like Amiloride, much less potent, more toxic.
Triamterene