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Unit 4 > Diuretics > Flashcards

Diuretics Flashcards

1
Q

What drugs are used to treat acute closed angle glaucoma?

A

Carbonic anhydrase inhibitor and beta blocker

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2
Q

Which 2 group of drugs should not be used with pt with closed angle glaucoma?

A

Anti M and alpha 1 agonist

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3
Q

What are the 2 ways of treating glaucoma and what drugs are used?

A 
Decrease aqueous production:
Beta blocker (Timolol)
Carbonic anhydrase inhibitor (acetazolamide) 
Increase drainage:
M3 agonist (pilocarpine)
Prostaglandin analog (latanoprost)
Mannitol
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4
Q

What is AChE inhibitor’s affect on your blood vessel?

A

None (M3 is not innervated)

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5
Q

When an organ/muscle doesn’t respond to indirect agonist but respond to direct agonist, what could be the reason behind that?

A

Denervation of the organ/muscle

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6
Q

Why ganglionic blocker produce a significant tachycardia with NE?

A

NE has alpha 1 and beta 1 affect—>reflex bradycardia results from alpha 1 affect—>if block reflex—>unopposed beta 1 results in significant tachycardia

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7
Q

For diuretics, hypokalemia goes with?

A

Alkalosis (K secretion is coupled with H secretion)

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8
Q

Mannitol is contraindicated in ___ and ___ pt?

A

CHF and pulmonary edema

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9
Q

How does carbonic anhydrase work?

A

Na/H antiporter transport H out to the urine—>H combine with HCO3- —>H2CO3—(carbonic anhydrase)—>CO2 and H2O—>CO2 goes into the cell—>combine with H2O—(carbonic anhydrase)—>H2CO3—>H + HCO3- —>HCO3- goes into the blood

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10
Q

What is carbonic anhydrase side effect and what else does it treat besides HTN?

A

Metabolic acidosis/hyperchloremia (later Cl- reabsorption)/renal stone (due to alkaline urine)
acute mountain sickness

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11
Q

Decrease in bicarb will always accompany with the increase of?

A

Cl-

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12
Q

How is Na reabsorbed in the thick ascending limb of the kidney?

A

Na is absorbed with K+ and Cl- via Na/K/2Cl cotransporter—>create + potential along the luminal membrane—>facilitate Mg and Ca absorption between cells

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13
Q

What are the electrolyte disturbance created by loop diuretics?

A

They block Na/K/2Cl contrasporter—>hypo Na/K/Cl/Mg/Ca
Alkalosis
Ototoxicity

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14
Q

What are the loop diuretics?

A

Furosemide/torsemide/ethacrynic acid

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15
Q

What is loop used for?

A

Pul edema/HF/hypercalcemia/HTN (thiazide is better)

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16
Q

Which loop does not elicit sulfonamide sensitivity?

A

Ethacrynic acid

17
Q

Loop with ___ increase risk for ototoxicity?

A

Aminoglycoside

18
Q

Which 2 drugs do loop interact with?

A

Li—>decrease Li clearance

Digoxin—>increase digoxin toxicity from hypokalemia

19
Q

What are the diuretics that contain sulfonamide?

A

Carbonic anhydrase inhibitor/loop except for ethacrynic acid/thiazide

20
Q

Where and how does thiazide diuretics work?

A

Block Na/Cl cotransporter at early distal tubule

21
Q

What are some thiazide?

A

HCTZ (hydrochlorothiazide)/chlorthalidone/indapamide

22
Q

What is thiazide used for mainly?

A

HTN (#1 choice)/calcium stone/CHF/nephrogenic diabetes insipidus

23
Q

How does thiazide treat nephrogenic diabetes insipidus?

A

Use HCTZ—>lose Na—>proximal tubule reabsorb Na to compensate—>water follows—>increase water reabsorption

24
Q

What are the side effect of thiazide?

A

Hypokalemia and alkalosis/hypercalcemia/hyperglycemia/hyperglycemia/hyperlipidemia

25
Q

How does thiazide cause hyperglycemia?

A

Thiazide—>hypokalemia—>keep K channel open in beta cell of pancreas—>inhibit insulin release—>hyperglycemia

26
Q

Beta block and thiazide can treat HTN but they both cause?

A

Hyperlipidemia

27
Q

Which 2 types of diuretics cause hyperuricemia?

A

Loop and thiazide

28
Q

What is the most common cause of hypokalemia and metabolic alkalosis?

A

Loop and thiazide diuretics

29
Q

Why loop and thiazide cause hypokalemia and alkalosis?

A

Inhibit Na reabsorption—>kidney try to compensate by reabsorb more Na at principle cell of collecting duct—>Na is reabsorbed and K and H are secreted—>hypokalemia and alkalosis

30
Q

What is the most common cause of hyperkalemia?

A

Renal failure

31
Q

Where else does carbonic anhydrase work besides proximal tubule?

A

Intercalated cells of collecting duct—>secrete H

32
Q

What are the 2 kinds of K sparing diuretics?

A

Na channel blocker—>amiloride/triamterene

Aldosterone receptor blocker—>spironolactone/eplerenone

33
Q

How does Li cause nephrogenic diabetes insipidus? and what treats it?

A

Li gets into principle cell of collecting duct—>damage V2 receptor—>don’t respond to ADH
Amiloride treats Li induced nephrogenic diabetes insipidus

34
Q

What pH disturbance do carbonic anhydrase and K sparing agents have?

A

Metabolic acidosis

35
Q

Difference between spironolactone and eplerenone?

A

Eplerenone is not antiandrogen

36
Q

Paring with what HTN drugs with K sparing diuretics might cause hyperkalemia?

A

ACEI or ARB

Unit 4 (28 decks)

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