Diuretics Flashcards

1
Q

MOA of osmotic diuretics

A

increase RBF, alter medullary tonicity so that tubular water reabsorption is osmotically blocked

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2
Q

Uses of osmotic diuretics (mannitol)?

A

localised oedema, glaucoma

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3
Q

ADRs of osmotic diuretics?

A

GI upset, injection site reactions, chills/fever, acute renal failure, CNS toxicity

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4
Q

MOA of CA inhibitors?

A

inhibit recycling of H+ secretion and Na+ reabsorption

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5
Q

Uses of CA inhibitors?

A

localised oedema e.g. glaucoma

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6
Q

MOA of loop/high ceiling diuretics?

A

acts at thick ascending limb, blocks Na+/K+/2Cl- symporter, block 15-25% of Na+ reabsorption

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7
Q

ADRs of loop diuretics

A

K+ wasting (dysrhythmias, ECG changes, increased digoxin toxicity, muscle weakness, constipation, drowsiness, irritability, confusion, dizziness), Na+ Mg2+ Ca2+ loss, impaired uric acid excretion, dose-related hearing loss

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8
Q

Uses of loop diuretics

A

APO, CHF, liver cirrhosis, renal failure, hypertension, in drug overdose, in combination with thiazides or K-sparing diuretics

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9
Q

MOA of thiazide and related diuretics?

A

increased Na+ excretion 5-10%, increased K+ excretion, decreased Ca2+ excretion

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10
Q

ADRs of thiazides and related diuretics?

A

hypokalaemia, hyperuricaemia, hypomagnesaemia, hypercholesterolaemia, hyperglycaemia, acid-base imbalance, erectile dysfunction, digoxin toxicity increased

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11
Q

K+ sparing diuretic drug groups?

A

aldosterone antagonists and Na+ channel blockers, act on late distal tubule and collecting ducts

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12
Q

MOA of aldosterone antagonists (spironolactone)

A

inhibit 3Na+/2K+ exchanger on basolateral membrane and luminal membrane Na+ channel

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13
Q

uses of aldosterone antagonists (like spironolactone)

A

with thiazides and loop diuretics to produce diuresis without hypokalaemia, used in conditions associated with hyperaldosteronism/Cushing’s, improves survival in CHF

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14
Q

MOA of Na+ channel blockers (amiloride)

A

blocks Na+ channel on luminal membrane

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15
Q

Uses of Na+ channel blockers (amiloride)

A

to spare K+ in the absence of aldosterone, used with thiazide and loop diuretics

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16
Q

What are some drug interactions with K+ sparing drugs leading to hyperkalaemia?

A
  • other K+ sparing diuretics
  • K+ supplements
  • ACE inhibitors
  • AT1 receptor antagonists