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Pharmacology > Diuretics > Flashcards

Diuretics Flashcards

0
Q

Furosemide Adverse Effects

A 
Loop, NKCC2
**Ototoxicity**
Hyperuricemia
Acute Hypovolemia
**Hypokalemia**
Hypomagnesemia
Allergies (Sulfa)
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1
Q

Furosemide Indications

A

Loop
NKCC2
DOC for acute pulmonary edema with heart failure
Hypercalcemia
Hyperkalemia
Ethacrynic acid is non-sulfa but more ototoxic

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2
Q

Torsemide indications

A

Loop, NKCC2
DOC for acute pulmonary edema with heart failure
Hypercalcemia
Hyperkalemia

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3
Q

Torsemide adverse effects

A 
Loop, NKCC2
**Ototoxicity**
Hyperuricemia
Acute hypovolemia
**Hypokalemia**
Hypomagnesemia
Allergies (sulfa)
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4
Q

Loop Diuretics Mechanism

A

NKCC2
Site-ascending LOH
Blocks Na/Cl/K co transporter
Increased prostaglandin synthesis (COX2)
Ethacrynic acid is non sulfa but more ototoxic, furosemide and torsemide are sulfa

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5
Q

Loop Diuretic Urine Composition

A

Increased calcium, sodium, potassium, magnesium

Increased volume

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6
Q

Thiazides Mechanism

A

NCCT
Site - DCT
Block Na/Cl co transporter
ceiling-saturates at low dose

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7
Q

Loop Effects

A

NKCC2
Ascending LOH Na/Cl/K cotransporter
Most effective DOC for acute pulmonary edema with heart failure
Produces a lot of urine
Increases renal blood flow via decreased resistance

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8
Q

Thiazide Effects

A

NKCC2
Site - DCT
Decreases PVR and BP even after volume recovery

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9
Q

Thiazide Indication

A

HTN
Mild heart failure
Hypercalciuria
Diabetes Insipidus

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10
Q

Thiazide Urine composition

A

Increased sodium, potassium, Chloride, Magnesium
Decreased Calcium
Increased volume

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11
Q

Thiazide Adverse effects

A 
Give oral only 
NKCC2 
Hypokalemia
Hyponatremia
Hyperuricemia
Volume depletion
**Hyperglycemia**
**Hyperlipidemia**

Takes 1-3 week to obtain stable effects

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12
Q

Thiazides

A

Chlorthalidone
Hydrchlorothiazide
Metolazone
(Sulfa derivatives)

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13
Q

Loops

A

Furosemide
Torsemide
Ethacrynic Acid

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14
Q

Aldosterone Agonists

A

Spironolactone

Eplerenone

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15
Q

Aldosterone Agonist Mechanism

A

Antagonizes aldosterone at cytoplasmic receptors (preventing translocation)
Acts at collecting duct
Used in combination with other diuretics

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16
Q

Aldosterone Antagonist Indication

A

Primary hyperaldosteronism

Edema

17
Q

Aldosterone Antagonist PK

A

Oral and strongly protein bound

Induces CYP450

18
Q

Aldosterone Antagonist Adverse Effects

A 
GI upset and peptic ulcers
**Endocrine->irregular menstrual cycles, gynecomastia, impotence**
Hyperkalemia
Nausea, Lethargy
Mental Confusion
19
Q

ENaC K sparing Drugs

A

Amiloride

Triamterene

20
Q

ENaC K Sparing Mechanism

A

Blocks Na transport channels
Decreases sodium/potassium exchange
Acts at collecting duct

21
Q

ENaC K sparing indications

A

Primary hyperaldosteronism
Heart failure
Hypokalemia

22
Q

ENaC K sparing Adverse effects

A

Same as spironolactone -GI upset and peptic ulcers, Endocrine issues (gynecomastia, impotence, irregular menstrual), Hyperkalemia, nausea, lethargy, mental confusion
Plus leg cramps**
Increased BUN, uric acid

23
Q

CAH inhibitor Drug

A

Acetazolamide

24
Q

CAH inhibitor Mechanism

A

Acts mainly in the PT

Prevents formation of H+ needed for Na+ reabsorption in the PT

25
Q

CAH inhibitor Indication

A

Glaucoma (decreases production of aqueous humor)
Treat metabolic alkalosis
Mountain sickness prophylaxis
Epilepsy

26
Q

CAH inhibitor Adverse effects

A

Metabolic acidosis
K depletion (rare)
Renal stones
Contraindicated in hepatic cirrhosis due to decreased NH4+ excretion

27
Q

Osmotic Drug

A

Mannitol

28
Q

Osmotic Effect

A

Does not affect sodium excretion

29
Q

Osmotic drug mechanism

A

Filtered into glomerulus, draws H2O into tubular fluid

30
Q

Osmotic drug indications

A

Increased ICP
Acute renal failure (shock)
Drug toxicity
Trauma (maintain urine)

31
Q

Osmotic PK

A

IV only

32
Q

Osmotic Adverse

A

Extracellular H2O expansion ->Dehydration
Hypo or hypernatremia
Oral->osmotic diarrhea

33
Q

ADH antagonist

A

Conivaptan

34
Q

Conivaptan

A

Inhibits CYP3A4

35
Q

ADH antagonist Effect

A

Renders CT impermeable to H2O

36
Q

ADH antagonist mechanism

A

Inhibit ADH

Decrease aquaporins in the collecting duct

37
Q

ADH antagonist indication

A

SIADH

Hyponatremia

38
Q

ADH antagonist Urine composition

A

Increased plasma Na

Decreased H2O reabsorption ->dilute urine

39
Q

ADH antagonist PK

A

IV only

40
Q

ADH antagonist adverse

A

Nephrogenic diabetes insipidus

Renal failure

41
Q

Diuretic main uses

A

Management of edema and hypertension

Pharmacology (24 decks)

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