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Pharmacology (Dale Turley) > Diuretics > Flashcards

Diuretics Flashcards

1
Q

Six classes of diuretics classified by ?

A

site of action in the nephron

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2
Q

Six classes of diuretics?

A

Thiazide

Thiazide-like

Loop

Potassium sparing

Osmotic

Carbonic anhydrase inhibitors

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3
Q

Inhibit NA/Cl transporter in the distal convoluted tubule

is the MOA of ?

A

Thiazide Diuretics (HCTZ)

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4
Q

Thiazide Diuretics (HCTZ) clinical uses?

A

Mild to moderate HTN, CHF, cirrhosis, renal insufficiency, nephrotic syndrome

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5
Q

Thiazide Diuretics (HCTZ) pharmacokinetics?

A

Rapid absorption after oral administration

Well distributed into extracellular space ( throughout the body )

Excreted unchanged by the kidneys

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6
Q

Hydrochlorothiazide (HCTZ)

use caution in?

A

renal impairment

gout

elderly

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7
Q

Hydrochlorothiazide (HCTZ)

causes?

A

hypokalemia

electrolyte imbalance

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8
Q

Hydrochlorothiazide (HCTZ)

pregnancy cat.?

A

B

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9
Q

Thiazide Diuretics: Adverse 
Reactions?

A

CV: hypotension
GU: erectile dysfunction (men)
META: metabolic alkalosis
it will change electrolytes and anion gap

Endo: hyperglycemia

GI: anorexia, nausea, cramping, vomiting

HEME: blood dyscrasias

MS: muscle cramps
remember we are reducing water weight

Neuro: dizziness, drowsiness, lethargy, weakness

Renal: azotemia

**warn them about orthostatic change initially **

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10
Q

Thiazide Diuretics could potentiate _______ toxicity

A

digoxin

  • *watch with incremental increases with Thiazide cause you can cause dig toxicity
  • *
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11
Q

________ reduce diuretic effect

A

NSAIDS

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12
Q

______ ____ potentiate hyperglycemia, hyperlipidemia

A

Beta blockers

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13
Q

______________ enhance hypokalemia

A

Corticosteroids

raises level of HCTZ

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14
Q

Get synergistic effect if used concurrent with loop diuretics?

A

Thiazide Diuretics

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15
Q

Bile acid resins bind and reduce _________ effect by 85%

A

Thiazide

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16
Q

Thiazide Diuretics may reduce effectiveness of?

A

lithium

warfarin

vitamin D

  • *so watch coumadin levels
  • *
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17
Q

Thiazide Diuretics: Conscientious Considerations?

A

Use with care if using insulin

Always review for possible drug interactions

Watch for drugs that alkalinize urine

Diuresis may be limited by dehydration

Perform initial determination of serum electrolytes, BUN uric acid, and glucose to monitor for electrolyte imbalances

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18
Q

Loop Diuretics

A

These are big!!!

Torsemide (Demadex)

Furosemide (Lasix)
works within 10 min

Bumetanide (Bumex)
doesn’t effect electrolytes like most of these do

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19
Q

Torsemide is?

A

Demadex

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20
Q

Furosemide is ?

A

Lasix

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21
Q

Bumetanide is?

22
Q

Loop Diuretics MOA?

A

Inhibit the Na/K/Cl cotransporter on the thick ascending Loop of Henle

Primary effect on prostaglandin synthesis

23
Q

Loop Diuretic also can cause?

A

Vascular and bronchial dilation

Auto-regulation of renal blood flow
people with RAS, or bad kidney function then this works very well

24
Q

Loop Diuretics patients have a risk of ?

A

hypocalcemia

hypokalemia

hyperglycemia

hyperuricemia

**this one drops both Na and K (not just K like thiazide) **

25
Q

Loop Diuretics produces?

A

transient diuresis not limited by dehydration

26
Q

Loop Diuretics may cause ?

A

Ototoxicity

May be enhanced by aminoglycoside use
synergistic effects

27
Q

Potassium-Sparing Diuretics example?

A

Sprinolactone - Aldactone

Triamterene

28
Q

Potassium-Sparing Diuretics MOA?

A

Inhibit Na reabsorption; dependent on K and H+ exchange

Block aldosterone receptor

29
Q

Potassium-Sparing Diuretics patients have a risk of ?

A

hyperkalemia

hyponatremia

metabolic acidosis

  • *drive K up and Na down
  • *
30
Q

Potassium-Sparing Diuretic is a ____ _______, usually used in combination with other diuretic classes

A

Weak diuretic

31
Q

___________ causes blue-colored urine

A

Triamterene

32
Q

_________ potentiate hyperkalemia

33
Q

Osmotic Diuretics examples?

A

Mannitol (Osmitrol)

34
Q

What diuretic adds solutes already present in renal tubular fluid?

A

Osmotic Diuretics

35
Q

How does Mannitol work ?

A

Water is pulled from the tubular fluid, resulting in less sodium and water to be reabsorbed

36
Q

Osmotic Diuretics are used in treatment of ?

A

Acute renal failure

Glaucoma

Cerebral edema

37
Q

Osmotic Diuretics pharmacokinetics?

A

mannitol is a sugar not well absorbed in the nephron —- osmotic pull of water—— diuresis

38
Q

Carbonic Anhydrase Inhibitors example?

A

Acetazolamide

39
Q

Acetazolamide is also used in?

A

Used for glaucoma

epilepsy (rarely)

idiopathic intracranial

hypertension

altitude sickness

40
Q

Carbonic anhydrase inhibition results in?

A

results in increased excretion of Na, K, and sodium bicarbonate

41
Q

CAI are the ________ of all diuretics

42
Q

CAI are mainly used in the tx of?

A

open-angle glaucoma

43
Q

CAI has a risk of what ?

A

Risk of Stevens-Johnson syndrome

erythema multiforme

toxic epidermal necrolysis

bone marrow suppression

44
Q

CAI: caution is advised with ?

A

high-dose ASA

45
Q

CAI cannot be used in patients with a _______.

A

sulfa allergy

46
Q

profofol _____ has sulfa in it but generic does not have sulfa in it ( so watch for surfer allergies)

47
Q

Aldosterone Antagonist example?

A

Spironolactone (Aldactone)

48
Q

Spironolactone (Aldactone)

class?

A

Potassium-sparing

49
Q

Spironolactone (Aldactone)

MOA?

A

antagonizes aldosterone-specific mineralocorticoid receptors primarily in the distal convoluted tubule

Decreasing Na and water reabsorption and increasing K retention

50
Q

Spironolactone (Aldactone)

monitoring parameters?

A

Cr, electrolytes at baseline then periodically

If severe heart failure, Cr, K 1wk after tx start or dose incr., then qmo x3mo, then q3mo x1y, then q6mo

**watch for peaked T’s **

Pharmacology (Dale Turley) (31 decks)

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