Diuretics

Question 1

Bumetanide

Answer 1

Bumex
Loop Diuretic
Most potent

Question 2

Furosemid

Answer 2

Lasix

Loop Diuretic

Question 3

Torsemide

Answer 3

Demadex

Loop Diuretic

Question 4

Ethacrymic Acid

Answer 4

Edercrin

Loop Diuretic - no longer used

Question 5

Loop Diuretic MOA

Answer 5

inhibition of the Na/K/2Cl symporter within the thick ascending limb of the loop pf henle

Question 6

Chlorothalidone

Answer 6

Hygroton
Thiazide/Thiadize -Like Diuretics
longest-half life
1.5x potent than HCTZ

Question 7

Hydrochlorothiazide (HTZ)

Answer 7

Microzide

Thiazide/Thiadize -Like Diuretics

Question 8

Indapamide

Answer 8

Lozol
Thiazide/Thiadize -Like Diuretics
Most Potent

Question 9

Metolazone

Answer 9

Zaroxolyn

Thiazide/Thiadize -Like Diuretics

Question 10

Thiazide/Thiazide-like Diuretics

Answer 10

inhibition of Na/Cl symporter within the distal convoluted tubule

Question 11

Potassium Sparing Diuretics: Na channel blockers MOA

Answer 11

inhibition of the renal epithelial Na channels resulting in decreased absorption of Na in the late distal tubule and collecting ducts and K+ is NOT excreted into lumen

Question 12

Amiloride

Answer 12

Midamor

Potassium Sparing Diuretics: Na channel blockers

Question 13

Triamterene

Answer 13

Dyrenium

Potassium Sparing Diuretics: Na channel blockers

Question 14

Potassium Sparing Drugs: Aldosterone Antagonists MOA

Answer 14

inhibition of aldosterone binding to the mineralcorticoid receptor to stimulate the expression of aldosterone induced proteins through nuclear translation. Aldosterone induced proteins increase the retention of K+

Question 15

Eplerone

Answer 15

Inspra
Potassium Sparing Drugs: Aldosterone Antagonists
AVOID CrCl < 50mg/dL; increased SCr and DM type 2 with albuminuria

Question 16

Spironolactone

Answer 16

Aldactone
Potassium Sparing Drugs: Aldosterone Antagonists
AVOID when CrCl < 30mg/dL

Question 17

Clinical Pearls of Thiazides

Answer 17

1. Diuretic Effect decreases with time
2. Takes 2-3 weeks for effects to begin - hold off before starting additional therapy
3. Chlorothaladone is 1.5x potent and has longer t1/2 than HCTZ
4. As dose increases electrolyte problems also increase

Question 18

Amiloride/HCTZ

Answer 18

Moduretic

Question 19

Triamterene/HCTZ

Answer 19

Dyazide/Maxide

Question 20

Spironolactone/HCTZ

Answer 20

Aldactazide

Question 21

Monitoring Parameters for Diuretics

Answer 21

1. Chem 7 (Na, K, BUN, Scr Glucose)

2. Baseline levels, 1-2 weeks, then q 6-12 months or initiating other agents that will effect electrolytes

Question 22

Loop Diuretics Clinical Pearls

Answer 22

1. limited use in hypertension; more used in heart failure
2. used more often in resistant HTN in presence of renal dysfunction
3. Can cause significant diuresis and electrolyte problems