diuretics

Question 1

what is mannitol

Answer 1

an osmotic diuretic

Question 2

mechanism of mannitol

Answer 2

inhibits water reabsorption in the tubule. this increases the volume of urine.

Question 3

what is the primary site of action for mannitol

Answer 3

the proximal tubule

Question 4

what are the uses for mannitol

Answer 4

increased intraocular pressure, increased intracranial pressure, oliguric states -rhabdo

Question 5

SE of mannitol

Answer 5

acute hypovolemia.

Question 6

acetozolemide/dorzolamide

Answer 6

carbonic anhydrase inhibitors

Question 7

what is the mechanism of the carbonic anhydrase inhibitors

Answer 7

decreases the formation of H+ in the cell and thus inhibits the uptake of both sodium and carbonate from the lumen. water follows and causes diuresis

Question 8

uses of carbonic anhydrase inhibitors

Answer 8

glaucoma, acute mountain sickness, metabolic alkalosis

Question 9

SE of carbonic anhydrase inhibitors

Answer 9

bicarbonaturia, acidosis, hypokalemia, hypercholremia paresthesis, renal stones, sulfonamide HSR

Question 10

what is the characteristic labs of someone using carbonic anhydrase inhibitor

Answer 10

hypokalemia and acidosis. unique

Question 11

what is the mechanism of the loop diuretics

Answer 11

inhibits the Na/K/2Cl transporter. within the thick ascending loop. there is decreased back diffusion of K+, decreased positive potential. this causes decreased reabsorption of Ca and Mg. diuresis.

Question 12

name some loop diuretics

Answer 12

ethacrynic acid, furosemide.

Question 13

what are the uses of loop diuretics

Answer 13

DOC for pulmonary edema and HF. also used for HTN, refractory edema, acute renal failure. anion OD. hypercalcemia.

Question 14

SE of loops

Answer 14

sulfonamide HSR, hypokalemia/alkalosis, hypocalcemia, hypomagnesemia, HYPERurecemia, OTOTOXICITY

Question 15

what is the only loop diuretic that does not cause HSR

Answer 15

ethacrynic acid

Question 16

what is the mechanism of the thiazides

Answer 16

blocks the Na/Cl pump in the distal tube. increases the Na/Cl concentration in the distal collecting duct. increases diuresis.

Question 17

what are the uses of thiazides

Answer 17

HTN, CHF, nephrolithiasis, nephrogenic DI.

Question 18

how do the thiazides treat HTN

Answer 18

by opening ATP dependent potassium channels. this causes vasodilation. also worsens DM

Question 19

SE of thiazides

Answer 19

sulfonamide HSR, hypokalemia/alkalosis, hypercalcemia, hyperuricemia. hyperglycemia and hyperlipidemia

Question 20

interactions for the thiazides

Answer 20

digoxin toxicity due to the electrolyte abnormalities.

Question 21

who should avoid being treated with thiazides

Answer 21

diabetics

Question 22

K+ sparing diuretic agents

Answer 22

spironolactone. amiloride, triemtorine

Question 23

mechanism of spironolactone

Answer 23

aldosterone receptor antagonist

Question 24

uses for spironolactone

Answer 24

hyperaldosteronism, adjunct to potassium wasting diuretic. antiandrogenic, CHF>

Question 25

SE for spironoloactone

Answer 25

hyperkalemia, acidosis, antiandrogenic.

Question 26

mechanism for amiloride, triemtorine

Answer 26

sodium channel blockers

Question 27

uses of amiloride, triemtorine

Answer 27

adjunct to K+ wasting. lithium induced nephrogenic DI.

Question 28

what is the SE for amiloride, triemtorine

Answer 28

hyperkalemia, acidosis