Diuretics Flashcards
carbonic anhydrase inhibitor
azetazolamide
osmotic diuretic
mannitol
Na/K/2Cl blockers (name 2)
furosemide
ethacrynic acid
Na/Cl blocker
hydrochlorothiazide
ENaC inhibitor
amiloride
aldosterone antagonists (name 2)
spironolactone
eplerenone
vasopressin antagonist
tolvaptan
ENaC is potassium _______ (sparing/wasting)
sparing
for hypertension, first line is ________ diuretics
thiazide
for edematous states, first line is _________ diuretics
loop
most diuretics are aimed at ________ ECFV by _________
reducing
excreting sodium
what stimulates the thirst response?
high osmolality of blood
immobile interstitial volume
bone
transcellular
dense connective tissue
the end game for diuretics is to ________
change the steady state (in=out) to a lower volume of body fluid
the phenomenon whereby diuretics cause a temporary increase in Na/H20 excretion with decrease in body weight, but then stabilize at a new steady state is called ________
diuretic braking
increases luminal sodium
carbonic anhydrase inhibitors
alkalinizes the urine
carbonic anhydrase inhibitors
increase in sodium to the DCT macula dense cells leads to ____________
increased EA relaxation and subsequent decrease in GFR
diuretic braking
can treat metabolic alkalosis
carbonic anhydrase inhibitor
increase bicarb excretion in urine
can treat Acute Mountain Sickness
carbonic anhydrase inhibitors
reduce accumulation of CO2
topically, can treat glaucoma
carbonic anhydrase inhibitors
reduce production of aqueous humor
renal stones
metabolic acidosis
cross hypersensitivity with sulfonamides
ADVERSE EFFECTS OF
carbonic anhydrase inhibitors
but usually well tolerated
secreted by OATS into tubular lumen
carbonic anhydrase inhibitors
loop diuretics
thiazide diuretics
loop diuretics decreasing potassium back leak leads to______
decreased Ca and Mg reabsorption
inhibits Na sensing mechanism in macula densa
loop diuretics
diuretic braking for loop diuretics is via _________
release of PGs and NO from macula dense, leading to increase in renin (and Na retention)
site of action: PT
CAIs
site of action: TALH
loop diuretics
first choice for hypertension with CHF
loop diuretic
hypokalemia arrhythmias r/t lyte depletion hypotension ototoxicity hyperuricemia ADVERSE EFFECTS OF
loop diuretics
decrease morbidity and mortality in HF patients
loop diuretics
increase luminal sodium and chloride
thiazides
decreases calcium excretion
thiazides
can use to treat hypercalciuria (prevent renal stones)
side of action: DCT
thiazides
___________ are frequently given with thiazides to minimize hypokalemia
ACE inhibitors
hypokalemia hypercalcemia hyperuricemia hyperglycemia hyperlipidemia ADVERSE EFFECTS OF
thiazides
decrease morbidity and mortality in pts with HF AND HTN
thiazides
increased luminal _______ in the collecting duct causes potassium excretion
sodium
MOA at principal cells
increased luminal _______ in the collecting duct causes H+ excretion
potassium
MOA at alpha-intercalated cells
secreted by OCT in PT
ENaC blockers
site of action: late DCT & CD
ENaC blockers
Aldosterone antagonists
Aldosterone antagonists are most effective when ________ levels are high
aldosterone (activated RAAS)
compared to spironolactone, eplerenone has decreased risk of _________
gynecomastia
given in conjunction with thiazide or loop diuretics to prevent loss of K+
ENaC blockers
aldosterone antagonists
reduces morbidity and mortality in HF when given in combo with loop or thiazide
aldosterone antagonists
not absorbed in the GI, must be given IV to be filtered into the kidney
mannitol
site of action: water permeable segments of nephron, mainly DLH
osmotic diuretics
used to reduce intracranial or intraocular pressure perioperatively
osmotic diuretics
site of action: CD
vasopressin (ADH) antagonists
used to treat SIADH
vasopressin antagonists