diuretics

Question 1

What’s the best diuretic for nephrotic syndrome, pulmonary oedema?

Answer 1

Loop diuretics

Question 2

Thiazides are useful for which three big clinical disorders?

Answer 2

diabetes insipidus… why??

hypertension

nephrolithiasis

Question 3

Which part of the nephron do thiazides work?

Also, give an example of a thiazide.

Answer 3

….. inhibiting sodium reabsorption at the beginning of the distal convoluted tubule

Bendroflumethiazide

(avoid alcohol if possible)

Question 4

What is nephrogenic diabetes insipidus?

Answer 4

There’s enough ADH in the body but the kidneys fail to respond to it. ADH = vasopressin

Question 5

Why do you need to be careful combining amiloride (similar to spironolactone) with ACE inhibitor?

Answer 5

both cause hyperkalaemia

Question 6

Why can thiazides be used to treat diabetes insipidus?

Answer 6

With diabetes insipidus the kidneys are not responding to ADH, and thus urine excretion is >>>

Thiazides have a paradoxical antidiuretic effect

Question 7

What is spironolactone an example of and when is it used?

Answer 7

Potassium-sparing diuretic

Best combined with other drugs when hypertension is not being controlled with other mixed. combinations.

Question 8

What is Spironolactone?

Answer 8

Potassium-sparing diuretics

Mineralocorticoid receptor antagonists = aldosterone receptor antagonists.

Question 9

Thiazides can cause hypokalaemia, but what’s their role with calcium?

Answer 9

used in treatment of kidney stones (caused by excessive calcium in the urine) as thiazides reduce calcium excretion.

Question 10

Where in the nephron does aldosterone and ADH act?

Answer 10

collecting ducts

Question 11

What’s bumetanide an example of?

Answer 11

Loop diuretic (i.e. furosemide)

Question 12

When would you use carbonic anhydrase inhibitors?

Answer 12

glaucoma

high-altitude sickness