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D&T3 Test 1 > Diuretics > Flashcards

Diuretics Flashcards

1
Q

What are 3 uses for diuretics

A
  1. mobilize fluid
  2. excrete fluid
  3. excrete electrolytes
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2
Q

name the prototype of drug for carbonic anhydrase inhibitor

A

Acetazolamide

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3
Q

MOA for Acetazolamide (CAI)

A

inhibits carbonic anhydrase in proximal tubule

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4
Q

what are 3 uses for Acetazolamide (CAI)

A
  1. open-angle gluacoma
  2. prophylaxis of acute mountain sickness
  3. not used as much today
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5
Q

how can Acetozolamide treat open-angle glaucoma

A
  • decreases aqueous humor formation
  • decreases intraocular pressure
  • used for chronic treatment
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6
Q

what are adverse effects of Acetozolamide

A
  • metabolic acidosis
  • hypokalemia
  • drowsiness
  • tingling of extremities (paresthesias)
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7
Q

what is the main Benzothiadiazide used

A

Chlorothiazide

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8
Q

name the related drugs of Benzothiazides

A
  1. chlorthalidone
  2. metalozone
  3. indapamide
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9
Q

MOA of benzothiazides

A
  • inhibition of sodium chloride co-transporter on the luminal membrane of distal tubular cells
  • less impact on proximal convoluted tubule
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10
Q

what are benzothiazides effects on urine composition

A
  • increase, Na, K, Cl, HCO3, H2O excretion

- decrease Ca excretion

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11
Q

What are 5 therapeutic uses of Benzothiazides

A
  1. hypertension
  2. congestive heart failure, cirrhosis, other edemetous states
  3. hypercalciuria
  4. nephrogenic diabetes insipidus
  5. nephrotic syndrome (+- Spironolactone)
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12
Q

What are 7 adverse effects of benzothiazides

A
  1. hypokalemia ( digitalis interaction)
  2. hypovolemia
  3. hypersensitivity
hyperGLUC
hyperGlycemia 
hyperLipidemia 
hyperUricemia (gout attacks)
hyperCalcemia
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13
Q

When are thiazides ineffective as diuretics

A

GFR less than 30-40 ml/min

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14
Q

What drugs are effective at lower GFR rates and can be used if GFR is less than 40 ml/min

A

Metolazone

Indapamide

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15
Q

Name 4 Loop Diuretic drugs

A

Furosemide
Bumetanide
Torsemide
ethacrynic acid

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16
Q

MOA of loop diuretics

A

inhibition of Na, K, 2Cl cotransporter in luminal membrane of ascending limb of the loop of henle

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17
Q

what are loop diuretics impact on urine composition

A
  • increase Na, K, Ca, Cl H2O excretion
  • +/- HCO3 at low doses
  • increase HCO3, PO4 at high doses
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18
Q

what are 4 therapeutic uses for loop diuretics

A
  1. acute pulmonary edema
  2. edema of cardiac hepatic or renal origin
  3. hypertension
  4. hypercalcemia
19
Q

What are 3 adverse effects of loop diuretics

A
  1. fluid and electrolyte imbalance
  2. ototoxicity; hearing loss then vestibular effect may be additive with other ototoxic drugs
  3. LDL, total cholesterol, total TG
20
Q

what are specific fluid and electrolyte imbalance for loop diuretics

A
  • hypovolemia
  • hyponatremia
  • hyperglycemia
    OH DANG
    otoxocity
    hypokalemia
    dehyrdation
    Allergy sulfa
    nephritis
    Gout
21
Q

Name the potassium - sparing diuretics

A

Spironolactone
Eplerenone
Trimeterene
Amiloride

22
Q

MOA for Sprionolactone and Eplerenone

A

competitively inhibits the binding of aldosterone to mineralocorticoid receptor in late distal tubule and collecting duct cells

23
Q

what are Spironolactone and Eplerenone impact on urine composition

A
  • increase Na, Cl, H2O excretion

- decrease K, and H

24
Q

what are therapeutic uses for Sprionolactone

A
  1. primary hyperaldosteronism
  2. prevent hypokalemia caused by thiazide or loop diuretics
  3. drug of choice in hepatic cirrhosis patients
25
Q

what are therapeutic uses for Eplerenone

A
  1. hyperkalemia

2. CHF post-MI

26
Q

What are adverse effects of Spironolactone and Eplerenone

A
  • hyperkalemia
  • gynecomastia in males
  • mestrual irregulars in females
27
Q

MOA of Trimeterene and amiloride

A

inhibit luminal Na channel in late distal tubule and collecting duct
- inhibition can be either competitive or noncompetitive

28
Q

what are therapeutic uses for Trimeterene and amiloride

A
  • secondary hyeraldosteronism

- prevent hypokalemia

29
Q

what are adverse effects of Trimeterene and Amiloride

A

hyperkalemia

30
Q

what is the mechanism of action for osmotic diuretics

A
  • freely filtered at the glomerulus, poorly reabsorbed from luminal fluid
  • excreted in urine water associated with drug provides the diuresis
31
Q

name some osmotic diuretics

A

Mannitol, Urea

32
Q

therapeutic uses for Mannitol

A
  1. maintain urine flow
  2. oliguric acid renal failure
  3. reduce intracranial or intraocular pressure
  4. not useful for mobilizing edema
33
Q

adverse effects of Mannitol

A
  1. over expression of the extracellular fluid

2. alteration of Na, K, levels in blood

34
Q

what drug are used to treat hypertension

A

thiazide
loop
postaissium-sparing

35
Q

drug used for chronic congestive heart failure

A

thiazide

loop potassium- sparing

36
Q

durg used for acute pulmonary edem

A

loop

37
Q

drug used for nephrotic syndonme

A

loop or thiazide, often with spironolactone

38
Q

drug used for chronic renal failure

A

loop or loop w/ metolazone of indapamide

39
Q

drug used for acute renal failure

A

mannitol and furosemide

40
Q

drug used for cirrhosis with ascites

A

spironolactone
Sprionoloactone and thiazide
spirnonolactone and loop

41
Q

drug used for hypercalcemia

A

furosemide

42
Q

drug used for diabetes insipdidous

A

thiazide

43
Q

drug used for open-angle glaucoma

A

carbonic anhydrase inhibitors

D&T3 Test 1 (11 decks)

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