Diuretics Flashcards

1
Q

Where do loop diuretics act?

A

The thick ascending limb of the loop of Henle

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2
Q

Mechanism of action of loop diuretics?

A

Block the triple co-transporter

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3
Q

What do loop diuretics do?

A

Prevent dilution of the filtrate in the TAL, increasing the load of Na+ reaching the late nephron

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4
Q

How do loop diuretics enter the nephron?

A

OAT

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5
Q

Example of a loop diuretic?

A

Furosemide

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6
Q

Indications for loop diuretic use?

A

Nephrotic syndrome
Acute hypercalcaemia
Hypertension
Chronic heart/kidney failure

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7
Q

Cons of loop diuretics?

A

Hypovolaemia
Hypotension
Calcium and magnesium depletion
Hypokaleamia

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8
Q

Where do thiazide diuretics act?

A

Early distal tubule

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9
Q

Mechanism of action of thiazide diuretics?

A

Block Na+/Cl- cotransporter

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10
Q

What do thiazide diuretics do?

A

Increase Na+ load reaching the late nephron

Increase calcium reabsorption

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11
Q

How do thiazide diuretics enter the nephron?

A

OAT

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12
Q

Example of a thiazide diuretic?

A

Bendroflumethiazide

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13
Q

Indications for thiazide diuretic use?

A

Mild heart failure
Hypertension
Renal stone disease
Nephrogenic diabetes insipidus

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14
Q

Cons of thiazide diuretics?

A

Hypovolaemia
Hypotension
Hypokalaemia
Magnesium depletion

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15
Q

Where do osmotic diuretics act?

A

Proximal tubule

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16
Q

How do osmotic diuretics enter the nephron?

A

Filtration

17
Q

Mechanism of action of osmotic diuretics?

A

Increase the filtrate osmolarity, opposing the reabsorption of water

18
Q

Example of an osmotic diuretic?

A

Mannitol

19
Q

Indications for use of osmotic diuretics?

A

Acute raised ICP/IOP

To prevent hypovolaemic renal failure to maintain urine flow

20
Q

Cons of osmotic diuretics?

A

Secondary hyponatraemia - increased fluid volume decreases sodium concentration and the gradient for its reabsorption

21
Q

Examples of potassium sparing diuretics?

A

Spironolactone

Amiloride

22
Q

Mechanism of action of amiloride?

A

Blocks apical Na+ channels

23
Q

Mechanism of action of spironolactone?

A

Competes with aldosterone, reducing Na+ reabsorption

24
Q

What do potassium sparing diuretics do?

A

Increase Na+ excretion and decrease K+ excretion

25
Q

Indications for potassium sparing diuretic use?

A

Hypertension
Heart failure
Primary and secondary hyperaldosteronism

26
Q

Cons of spironolactone?

A

Gynaecomastia

27
Q

How do carbonic anhydrase inhibitors work?

A

Increase bicarbonate excretion along with Na+, K+ and H2O

28
Q

Cons of carbonic anhydrase inhibitors

A

Cause an alkaline urine and metabolic acidosis

29
Q

No longer used as diuretics but used instead for:

A

Glaucoma
Altitude sickness prophylaxis
Infantile epilepsy

30
Q

Where do carbonic anhydrase inhibitors act?

A

Proximal tubule

31
Q

Example of carbonic anhydrase inhibitor?

A

Acetazolamide