Diuretics

Question 1

Loop Diuretics

Answer 1

Furosemide

Bumetanide

Torsemide

Uses: pulmonary/peripheral edema due to heart failure

Mechanism: inhibit the Na-2Cl-K contransporter in thich ascending loop of henle. Results in excretion of 20-25% of filtered Na. Because impairs hypetonic interstitium, gradient for water movenment out of collecting duct decreases

Side Effects: hypotension, hypokalemia, hypomagnesia, metabolic alkalosis, hyperglycemia, occasional ototoxcity secondary to electrolyte disturbances of endolympatic system.

Question 2

Thiazides

Answer 2

Hydrochlorithiazide (PO)

Chlorthalidone (PO)

Metolazone (PO)

less potent that loop diuretics but longer duration

Side Effects: electrolyte distubances similiar to loop diuretics, hypertryglyceridemia, hypercholestrolemia, hyponatremia, hyperglycemia

Usese: hypertension (proven benefit in reducing stroke and MI) and heart failure

Question 3

Potassium Spating Diuretics

Answer 3

Spironolactone, Eplerenone

relatively weak

Side Effects: hyperkalemia (esp together with ACEi or ARBs), gynecomastia and menstraul irregulariuties