Diuretics 3

Question 1

Loop diuretics decrease the capacity of the kidney

Answer 1

to concentrate and dilute the urine in response to

decreased and increased water consumption.

Question 2

Thiazide diuretics decrease the capacity of the kidney

Answer 2

to dilute the urine in response to increased water

consumption.

Question 3

what are the 3 types of diuretics that work on proximal tubule?

Answer 3

1. carbonic anhydrase inhibitors
2. aminophylline = theophylline
3. osmotic diuretics

Question 4

what are the 3 names of the carbonic anhydrase inhibitors?

Answer 4

1. acetazolamide
2. methazolamide
3. dichlorphenamide

Question 5

what are the 4 names of osmotic diuretics?

Answer 5

1. mannitol
2. excess glucose
3. urea
4. isorbide

Question 6

what are the diuretics that work on medullary and cortical thick ascending loop of Henle?

Answer 6

loop diuretics or high ceiling diuretics

Question 7

what are the 4 names of the loop diuretics?

Answer 7

1. furosemide (has sulfonamide hypersensitivity rxn)
2. bumetanide
3. torsemide
4. ethacrynic acid (non-sulfar,so DOC for sulfar allergy)

Question 8

what type of diuretics work in the early distal tubule?

Answer 8

thiazide diuretics

Question 9

Name the 2 thiazide diuretics?

Answer 9

1. chlorothiazide

2. hydrochlorothiazide

Question 10

Name the 4 thiazide-like diuretics

Answer 10

1. chlorthalidone
2. quinethazone
3. metolazone
4. indapamide

Question 11

what types of diuretic work on late distal tubule and collecting duct?

Answer 11

K+ sparing agents

1. renal epithelial sodium channel inhibitors: amiloride, triamterene
2. aldosterone receptor antagonist spironolactone

Question 12

what are the 3 names of the inhibitors of carbonic anhydrase?

Answer 12

1. acetazolamide
2. methazolamide
3. dichlorphenamide

Question 13

what are the structural commonality of the carbonic anhydrase and what side effect does it lead to?

Answer 13

sulfar group and sulfonamide hypersensitivity

Question 14

what is the mech of carbonic anhydrase inhibitors?

Answer 14

induce a moderate increase in urine volume with increased excretion of sodium, potassium and bicarbonate in an alkaline urine

Question 15

what is the effect of potassium conc and bicarbonate conc due to carbonic anhydrase inhibitors?

Answer 15

1. hypokalemia

2. reduced bicarb –> metabolic acidosis

Question 16

what are the 2 main side effects of carbonic anhydrase inhibitors (acetazolamide, dorzolamide)?

Answer 16

1. hypokalemia

2. metabolic acidosis

Question 17

what are the other important side effects of carbonic anhydrase inhibitors?

Answer 17

1. accumulation of ammonia

2. hepatic encephalopathy –> contraindicated in pts with cirrhosis

Question 18

what are the 4 clinical usage of mannitol?

Answer 18

1. to increase the clearance of drugs
2. to minimize renal failure during shock or surgery
3. to decrease intraocular and intracranial pressure
4. to diagnose oliguria

Question 19

what are the 4 names of the high ceiling diuretics?

Answer 19

1. ethacrynic acid
2. furosemide
3. bumetamide
4. torsemide

Question 20

what is the unique characteristics of high ceiling/loop diuretics?

Answer 20

most efficacious of the diuretics

Question 21

what are the main side effects of loop diuretics?

Answer 21

1. alkalosis & hypokalemia
2. hyperuricemia
3. increased BUN and serum creatinine

Question 22

the clinical application of the loop diuretics arise from the prompt onset of an exceptionally large diuresis, what are the 3 main clinical usage of loop diuretics?

Answer 22

1. crisis episodes of pulmonary edema and edema resulting from CHF, cirrhosis
2. hypercalcemia
3. drug toxicity

Question 23

what are the other clinical complications of loop diuretics?

Answer 23

1. hypokalemia-diabetes
2. hyponatremia
3. hyperuricemia
4. increased BUN and serum creatinine

Question 24

what toxicity can be developed using loop diuretics with aminoclycoside antibiotics?

Answer 24

ototoxicity