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MET 2 > Diuretics > Flashcards

Diuretics Flashcards

1
Q

What is the general aim of any diuretic

A

To diminish sodium reabsorption at different point in the nephron
Increase urinary sodium and water loss

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2
Q

At which point in the loop of Henle is there the highest concentration

A

The bottom of the loop

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3
Q

What is the overall aim of the counter-current mechanism in the loop of Henle

A

To create an electrical gradient

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4
Q

What is reabsorbed in the proximal tubule

A

glucose, aa, phosphate

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5
Q

What moves out of the descending limb of the loop of henle

A

water

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6
Q

What moves into the ascending limb of the loop of henle

A

potassium

hydrogen Nh3

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7
Q

Name the 5 classes of diuretic

A
  • Carbonic anhydrase inhibitors
  • Loop
  • Thiazide
  • Potassium sparing diuretics
  • Osmotic diuretics
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8
Q

Name a type of carbonic anhydrase diuretic

A

Acetazolamide

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9
Q

Where do CA diuretics work

A

Proximal convuluted tubule

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10
Q

Usual role of carbonic anhydrase enzyme

A
  • Converts H2C03 to H20 and CO2 in the lumen

- Converts CO2 and H20 into H2CO3 in the pct

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11
Q

How do carbonic anhydrase inhibitors work as diuretics

A

Inhibits transport of bicarbonate out of the proximal convuluted tubule into the interstitium
Leads to less sodium reabsorption and therefore greater sodium bicarbonate and water loss in the urine

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12
Q

What are the real life main uses of acetazolamide

A
  • Glaucoma
  • Epilepsy
  • Mountain Sickness
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13
Q

What are the side effects of carbonic anhydrase inhibitors

A
  • Metabolic acidosis
  • Sedation
  • Bone marrow suppresion
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14
Q

Name 2 loop diuretics

A

Fresemide

Bumetanide

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15
Q

Where do loop diuretics work

A

Ascending limb of loop of henle

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16
Q

Which transporter does the loop diuretic block

A

Na+/ K+/ 2cl- sympoter

17
Q

How do loop diuretics work

A
  • Block Na+/ K+/ 2Cl- sympoter
  • Inhibits uptake of these
  • Loop diuretics also inhibit potassium and calcium uptake because their uptake is reliant on charge
  • Prevents loop from becoming hypertonic so reduces osmotic charge
  • Increased urine production
18
Q

What is excreted in loop diuretics

A

Potassium, sodium, water, magenesium

19
Q

What are some indications for loop diuretics

A

Hypertension
Heart failure
Volume overload from CKD

20
Q

Side effects of loop diuretics

A

Hypokalaemia
Dehydration
Kidney stones
Deafness

21
Q

Name 2 thiazide diuretics

A

Bendroflumethiazide

Hydrochlorothiazide

22
Q

Where do thiazide diuretics work

A

Blocks Na+/Cl- transporter in distal convuluted tubule

23
Q

Main uses for thiazide

A

Antihypertensive

Reduces plasma volume and peripheral resistance

24
Q

Side effects of thiazide diuretics

A 
Hypokalaemia
Hypocalcaemia
Hyponatraemia
Hyperglycaemia
Hypercholsteroaemia
25
Q

2 types of potassium sparing diuretics

A

Epithelial Na channel antagonists

Aldosterone antagonists

26
Q

Name 2 epithelial sodium channel antagonists

A

Amiloride

Triamterene

27
Q

Name 2 aldosterone antagonists

A

Spironolactone

Eplerenone

28
Q

What does amiloride target

A

Na+ channel in the collecting tubule

By blocking transport, more sodium is excreted by spares potassium loss

29
Q

Indications to use amiloride

A

Heart failure
Hypokalaemia from other diuretics
Cirrhosis

30
Q

Side effects of amiloride

A

Hyperkalaemia

Hyponatraemia

31
Q

Indications to use aldosterone blockers

A

Hyperaldosteronism
Heart failure
Hypokalaemia
Cirrhosis

32
Q

Side effects of aldosterone blockers

A

Hyperkalaemia
Glynecomastia
Hyponatraemia

33
Q

Define osmotic diuretic

A

Any osmotically active molecule that is freely filtered from the glomerulus and not reabsorbed by the tubules

34
Q

Name an osmotic diuretic

A

Mannitol

35
Q

Clinical indications for using osmotic diuretic

A

Cerebral oedema

Oliguric acute renal failure

36
Q

Side effects of osmotic diuretics

A

Transient fluid overload

Pulmonary oedema

37
Q

When should you not use any diuretic

A

Hypotension
Dehydration
POST SURGERY

38
Q

When should you not use loop/ thiazide diuretics

A

When hypokalaemic

39
Q

When should you not use amiloride/ aldosterone antagonists

A

When hyperkalaemic

MET 2 (32 decks)

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