Diuretics 3 Flashcards
Loop diuretics decrease the capacity of the kidney
to concentrate and dilute the urine in response to
decreased and increased water consumption.
Thiazide diuretics decrease the capacity of the kidney
to dilute the urine in response to increased water
consumption.
what are the 3 types of diuretics that work on proximal tubule?
- carbonic anhydrase inhibitors
- aminophylline = theophylline
- osmotic diuretics
what are the 3 names of the carbonic anhydrase inhibitors?
- acetazolamide
- methazolamide
- dichlorphenamide
what are the 4 names of osmotic diuretics?
- mannitol
- excess glucose
- urea
- isorbide
what are the diuretics that work on medullary and cortical thick ascending loop of Henle?
loop diuretics or high ceiling diuretics
what are the 4 names of the loop diuretics?
- furosemide (has sulfonamide hypersensitivity rxn)
- bumetanide
- torsemide
- ethacrynic acid (non-sulfar,so DOC for sulfar allergy)
what type of diuretics work in the early distal tubule?
thiazide diuretics
Name the 2 thiazide diuretics?
- chlorothiazide
2. hydrochlorothiazide
Name the 4 thiazide-like diuretics
- chlorthalidone
- quinethazone
- metolazone
- indapamide
what types of diuretic work on late distal tubule and collecting duct?
K+ sparing agents
- renal epithelial sodium channel inhibitors: amiloride, triamterene
- aldosterone receptor antagonist spironolactone
what are the 3 names of the inhibitors of carbonic anhydrase?
- acetazolamide
- methazolamide
- dichlorphenamide
what are the structural commonality of the carbonic anhydrase and what side effect does it lead to?
sulfar group and sulfonamide hypersensitivity
what is the mech of carbonic anhydrase inhibitors?
induce a moderate increase in urine volume with increased excretion of sodium, potassium and bicarbonate in an alkaline urine
what is the effect of potassium conc and bicarbonate conc due to carbonic anhydrase inhibitors?
- hypokalemia
2. reduced bicarb –> metabolic acidosis
what are the 2 main side effects of carbonic anhydrase inhibitors (acetazolamide, dorzolamide)?
- hypokalemia
2. metabolic acidosis
what are the other important side effects of carbonic anhydrase inhibitors?
- accumulation of ammonia
2. hepatic encephalopathy –> contraindicated in pts with cirrhosis
what are the 4 clinical usage of mannitol?
- to increase the clearance of drugs
- to minimize renal failure during shock or surgery
- to decrease intraocular and intracranial pressure
- to diagnose oliguria
what are the 4 names of the high ceiling diuretics?
- ethacrynic acid
- furosemide
- bumetamide
- torsemide
what is the unique characteristics of high ceiling/loop diuretics?
most efficacious of the diuretics
what are the main side effects of loop diuretics?
- alkalosis & hypokalemia
- hyperuricemia
- increased BUN and serum creatinine
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?
- crisis episodes of pulmonary edema and edema resulting from CHF, cirrhosis
- hypercalcemia
- drug toxicity
what are the other clinical complications of loop diuretics?
- hypokalemia-diabetes
- hyponatremia
- hyperuricemia
- increased BUN and serum creatinine
what toxicity can be developed using loop diuretics with aminoclycoside antibiotics?
ototoxicity
