Diuretics Flashcards
Main determinant of ECF volume?
Na
Acetazolamide
Carbonic Anhydrase Inhibitor at PT Urine: alkali d/t HCO3 Plasma: dec HCO3, Cl Tx: mountain, intraocular, alkalosis AE: renal stones, cross sens sulfonamides
Furosemide (Lasix)
Loop diuretic Na/K/2Cl at TALH Urine: inc excretion of all Tx: edema, HTN (esp in CHF) AE: arrhythmia, hypotension, ototoxic, gout
Ethacrynic acid
Loop diuretic
Na/K/2Cl at TALH
Bumetanide
Loop diuretic
Na/K/2Cl at TALH
Which type of diuretics are best for decreasing blood volume?
Loop diuretics
Furosemide, ethacrynic acid, bumetanide
Which diuretics are K+ wasting and have AE of hypokalemia?
Loop diuretics
Thiazide diuretics
HCTZ
Thiazide diuretic
Na/Cl at DCT
Urine: dec Ca excretion
Tx: HTN, CHF, hypercalciuria, nephrogenic DI
AE: hypercalcemia, hyperglycemia/lipidemia
Which K+ wasting diuretics abolish the osmotic gradient and which do not?
Abolish: loops
Don’t abolish: thiazide
Which diuretics are considered “calcium sparing”?
thiazides
Chlorthalidone
Thiazide diuretic
NaCl at DCT
Indapamide
Thiazide diuretic
NaCl at DCT
Amiloride
ENaC inhibitor at late DCT/CD
K sparing (hyperk)
Given w/ thiazides or loops
Works w/o aldosterone
Triamterene
ENaC inhibitor at DCT/CD
K sparing
Spironolactone
Aldosterone antag at late DCT/CD
K sparing (hyperk)
Given w/ loop or thiazide
Gynecomastia
Eplerenone
Aldosterone antag at late DCT/CD
K sparing
Mannitol
Osmotic diuretic Inc osmolality, ECF, RBF Urine: inc Mg Plasma: hypo then hypernatremia Tx: reduce intracranial and ocular pressure AE: edema, CHF, hyperk (chronic)
Isosorbide
Osmotic diuretic
Which is the only diuretic to increase RBF?
Osmotic (and loop)
Which diuretic decreases RBF?
Carbonic anhydrase inhibitor
Tolvaptan
Vasopressin/ADH antag
Works at V2 ADH receptors in CD
Tx for SIADH
AE: hypernatremia
