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Pharmacology > Diuretics > Flashcards

Diuretics Flashcards

1
Q

How do mercuric compounds work?

A

Inhibit sodium reabsorption in proximal tubules

no longer used due to adverse effects

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2
Q

How do osmotic diuretics work?

A

prevent reabsorption of sodium and water from proximal tubule

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3
Q

What is an adverse affect of an osmotic diuretic?

A

Can cause rapid shift of fluid from interstitial compartment to vascular compartment, causing pulmonary edema or increased cardiac workload

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4
Q

What is mannitol used to treat? How is it administered?

A

Cerebral edema and elevated ICP

Not absorbed in G.I. tract – must be given IV

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5
Q

Give the equation for central perfusion pressure

A

CPP = MAP - ICP

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6
Q

Who commonly uses glycerin as a diuretic?

A

Weightlifters swallow glycerin to decrease water weight due to osmotic diuretic effect

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7
Q

What are aquaretics? Give an example

A

ADH receptor blockers that increase urine production (Demeclocycline)

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8
Q

What kind of drug can be used to treat patients with SIADH?

A

Demeclocycline

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9
Q

Which patients commonly have SIADH?

A

Neuro patients with head trauma/increased ICP

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10
Q

What were the first diuretics used?

A

Mercury containing compounds

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11
Q

How do you carbonic anhydrase inhibitors work?

A

They inhibit reabsorption of bicarbonate, causing bicarb waste and water waste

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12
Q

What is a potentially serious adverse reaction of carbonic anhydrase inhibitors?

A

Hypokalemia due to additional waste of potassium

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13
Q

What are carbonic anhydrase inhibitors mainly used for?

A

Management of glaucoma – lower intraocular pressure by decreasing aqueous humor production

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14
Q

Why can carbonic anhydrase inhibitor’s affect excretion of other drug products?

A

Changes in the blood and urine pH alter excretion of drugs

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15
Q

What drugs do carbonic anhydrase inhibitors cross react with?

A

Sulfonamides- can cause rash

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16
Q

Which diuretic can be used to treat altitude sickness?

A

Carbonic anhydrase inhibitors – hemoglobin discharges oxygen for increased consumption if blood becomes acidotic (potential effect of CAIs)

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17
Q

What is the only CAI on the market?

A

Acetazolamide (Diamox)

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18
Q

How do thiazides work?

A

Prevent reabsorption of sodium and water at the distal tubule

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19
Q

What is the minimum creatinine clearance at which thiazides can be used?

A

30 mL per minute

20
Q

What diuretic should be used in cases of reduced CrCl?

A

Loop diuretics

21
Q

List five electrolyte related side effects of thiazides

A

Hypokalemia, hypomagnesemia, hyperuricemia, hyperglycemia, hypercalcemia

22
Q

Which patients should not take thiazides?

A

Patients with gout due to thiazide causing increased uric acid production

23
Q

How quickly do thiazides take effect?

A

1 to 2 hours

24
Q

Which type of diuretics cause photosensitivity?

A

Thiazide – patient should wear sunscreen with at least 15 SPF

25
Q

Why are diuretics extra helpful in postmenopausal women?

A

They cause calcium retention, slowing osteoporosis

26
Q

What time of day should thiazides be taken?

A

Best in morning, no later then 1700 (5:00)

27
Q

What is the most common thiazide used?

A

HCTZ

28
Q

Which diuretics are known as high ceiling diuretics and high efficacy diuretics?

A

Loop diuretics

29
Q

Which type of loop diuretics are more potent and bioavailable?

A

Bumetanide (#1) and torsemide (#2) (2-4x more effective then furosemide)

30
Q

How do Loop diuretics work?

A

They block sodium rehab sorption in the loop of Henle

31
Q

How can ototoxicity be prevented in administration of Loop diuretics?

A

Administer slowly over 2 to 3 minutes to avoid ringing in ears

32
Q

List the two potassium sparing diuretics

A

Aldosterone antagonists and nonsteroidal potassium sparing diuretics

33
Q

How do aldosterone antagonists work?

A

They antagonize aldosterone’s actions: aldosterone Binds to receptors in the distal tubules to stimulate reabsorption of sodium and water and potassium excretion

34
Q

Must be present for Spironolactone to be effective?

A

Aldosterone – patient must have functional adrenal gland

35
Q

List two potential side effects of aldosterone antagonists

A

Hyperkalemia and gynecomastia

36
Q

List four uses of Spironolactone

A

Hypertension, hirtuism, primary aldosteronism, cirrhosis

37
Q

Why should salt substitutes be avoided when taking aldosterone antagonists?

A

Salt substitutes often contain potassium rather than sodium and can contribute to hyperkalemia

38
Q

Which diuretic is better for patients with gout?

A

Aldosterone antagonists

39
Q

Name the Second generation aldosterone antagonist with reduced affinity for estrogen receptors

A

Eplerenone (Inspra)

40
Q

How do nonsteroidal potassium sparing diuretics work?

A

Exact mechanism unknown, but affect reabsorption of sodium from the distal tubule

41
Q

Which diuretics are considered low efficacy?

A

Potassium sparing

42
Q

What are three electrolyte related side effects of nonsteroidal potassium sparing diuretics?

A

Hyperkalemia, hypercalcemia, hypomagnesemia

43
Q

List two Nonsteroidal potassium sparing diuretics often found in combination with HCTZ

A

Triamterene and amiloride

44
Q

List five treatments for hyperkalemia in order of ascending strength

A

Potassium wasting diuretic, SPS (Kayexalate), bicarbonate, insulin with D5W, calcium chloride

45
Q

What is the fastest that potassium should be replaced?

A

No faster than 10 mEq per hour

46
Q

Which osmotic diuretic is shown to reduce cerebral edema and manage elevated ICP?

A

Mannitol

Pharmacology (9 decks)

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