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Pharmacology > Diuretics > Flashcards

Diuretics Flashcards

1
Q

Thiazide Diuretics Meds

A
  • hydrochlorothiazide
  • chlorthalidone
  • metalozone
  • indapamide
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2
Q

Thiazide Diuretics MOA

A

decreases sodium and chloride reabsorption in distal convoluted (more Na+ and Cl- excreted)

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3
Q

Thiazide Diuretics AEs

A
  • hypokalemia
  • hypomagnesmia
  • hyperuricemia
  • hyperglycemia
  • hyperlipidemia
  • diuresis
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4
Q

Thiazide Diuretics Caution

A
  • when renal function declines with age

- if risk for metabolic effects (increased uric acid, insulin resistance)

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5
Q

Thiazide Diuretics Interactions

A
  • steroids cause salt retention-> decreasing effect of thiazide
  • NSAIDs blunt thiazide response
  • Class IA or III antiarrhythmics prolongs QT interval which may cause torsades with diuretic-induced hypokalemia
  • probenacid and lithium block thiazide effects by disrupting its excretion
  • thiazides decrease lithium clearance and may cause toxicity
  • hypokalemia with digoxin may increase risk of toxicity
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6
Q

Thiazide Diuretics Special Notes

A
  • BEST DIURETIC FOR HTN
  • chlorthalidone is 1.5-2x more effective than HCTZ
  • HCTZ is just as effective at 12.5 mg than 25 or 50 mg doses
  • dose in the morning
  • not effective when GFR <30
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7
Q

Loop Diuretics Meds

A
  • furosemide
  • torsemide
  • bumetanide
  • ethacrynic acid
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8
Q

Loop Diuretics MOA

A
  • blocks Na+ and Cl- reabsorption at the ascending loop of Henle
  • decreases renal vascular resistance and increased renal blood flow
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9
Q

Loop Diuretics Dosing

A
  • start low and titrate
  • taper slowly
  • in morning to prevent nocturia
  • there is a ceiling dose but you can increase frequency, do a continuous infusion, or combine with a thiazide
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10
Q

Loop Diuretics AEs

A
  • hypokalemia
  • hypomagnesmia
  • hypocalcemia
  • excessive diuresis
  • reflex activation of RAAS
  • hypouricemia
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11
Q

Loop Diuretics Monitoring

A
  • electrolytes

- renal functioning (CrCl, GFR)

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12
Q

Loop Diuretics Interactions

A
  • aminoglycosides can cause ototoxicity when combined
  • NSAIDs block diuretic response
  • Class IA or III antiarrhythmics prolong QT and with diuretic-induced hypokalemia may cause torsades
  • probenacid blocks loop diuretics by stopping excretion
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13
Q

Loop Diuretics Caution

A
  • any drug that can aggravate hyperglycemia, dyslipidemias, hyperuricemia
  • kidney functioning with ACE I or ARBs
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14
Q

Potassium Sparing Diuretics Meds

A
  • amiloride

- triamterene

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15
Q

Potassium Sparing Diuretics MOA

A

inhibits sodium transport at late distal and collecting ducts

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16
Q

Potassium Sparing Diuretics AEs

A
  • hyperkalemia
17
Q

Potassium Sparing Diuretics Monitoring

A

renal functioning

K+

18
Q

Potassium Sparing Diuretics Interactions

A
  • ACE Is may increase risk of hyperkalemia
  • indomethacin decreases renal functioning when combined with triamterene
  • cimetidine increases bioavailability and decreases clearance of triamterene
19
Q

Potassium Sparing Diuretics Special Notes

A
  • used in combination with loops or thiazides to reduce K+ loss
20
Q

Aldosterone Antagonists Meds

A
  • spironolactone

- eplerenone

21
Q

Aldosterone Antagonists MOA

A
  • increases NaCl excretion, decreases K+ excretion

- modulates vascular tone

22
Q

Aldosterone Antagonists AEs

A
  • hyperkalemia
  • dyncomastia/breast tenderness (spironolactone)
  • menstrual irregularities
  • Hirsutism
23
Q

Aldosterone Antagonists Cautions

A
  • elderly
  • diabetic patients
    • these groups have increased risk of hyperkalemia
24
Q

Aldosterone Antagonists Interactions

A
  • ACE Is/ARBs/NSAIDs increase hyperkalemia
  • Digoxin with spironolactone causes increased plasma concentration
  • K+ supplements increase risk of hyperkalemia
25
Q

Eplerenone Interaction

A
  • CYP3A4 substrate
26
Q

Aldosterone Antagonists Dosing

A
  • initiates spironolactones at 12.5-25 mg
  • initiate eplerenone 25 mg daily; up to 50 mg daily
  • decrease/stop K+ supplements or avoid high potassium foods
  • stop or reduce if K+>5.5 mEq/L
  • reduce/stop with worsening renal functioning
27
Q

Aldosterone Antagonists Special Note

A

diminish cardiac remodeling in HR

Pharmacology (7 decks)

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