Diuretics

Question 1

What is a natriuretic

Answer 1

Something that increases renal sodium excretion

Question 2

What is a aquaretic

Answer 2

Something that increases excretion of solute-free water

Question 3

What do carbonic anhydrase inhibitors do?

Answer 3

Decreases bicarb reabsorption, which decreases intracellular H+ which affects the H gradient for the NEH (Na H antiporter) (decreases absorption of Na)

Question 4

Where do carbonic anhydrase inhibitors work? What are some examples

Answer 4

Proximal tubule; acetazolamide

Question 5

What are loop diuretics

Answer 5

Drugs that inhibit the NKCC2 transporter

Question 6

Where do loop diuretics work

Answer 6

LoH

Question 7

What is our example of loop diuretics

Answer 7

Furosemide

Question 8

What are loop diuretics used to treat? What are some side-effects?

Answer 8

First line for systemic edema

Can induce hypokalemic metabolic alkalosis

Increases Ca and Mg excretion

Question 9

What are thiazides?

Answer 9

Drugs that target the NaCl symporter

Question 10

Where do thiazide drugs work

Answer 10

Distal tubule

Question 11

What are thiazides used to treat? What are some side effects?

Answer 11

Hypertension and edema states

Enhances Ca reabsorption which can be used for Ca containing kidney stones

Question 12

What are potassium sparing diuretics? What are the types?

Answer 12

Diuretics that act in areas of K change by decreasing Na reabsorption and reducing K excretion

Aldosterone antagonist
ENaC blocker

Question 13

Where do potassium sparing diuretics act

Answer 13

Late DT and CCD

Question 14

What are our aldosterone antagonists? What class are they

Answer 14

Spironolactone and Eplerenone

Potassium sparing diuretics

Question 15

What are our ENaC blockers

Answer 15

Amiloride and Triamterene

They are potassium sparing diuretics

Question 16

Where do osmotic diuretics act

Answer 16

PT and DLoH

Question 17

What is our main osmotic diuretic

Answer 17

Mannitol

Question 18

What properties do the osmotic diuretics have

Answer 18

Freely filtered at glomerulus and poorly reabsorbed

Question 19

What are the effects of osmotic diuretics

Answer 19

Urine volume increased and sodium excretion increased (b/c urine flow is going fast enough that Na transporters can’t take up all the Na flowing by)

Question 20

What is the general effect of diuretics on K

Answer 20

Increase secretion of K (except K sparing diuretics)

Question 21

Loop diuretics do what to calcium

Answer 21

Increased excretion of Ca; can be used to treat hypercalcemia

Question 22

What do thiazide diuretics do for Ca

Answer 22

Stimulate reabsorption in DT through activation of TRPV5

Also used to treat calcium containing kidney stones

Question 23

What do diuretics do for Pi

Answer 23

Acutely increase Pi excretion (except K sparing diuretics)

Question 24

Where is Mg primarily reabsorbed

Answer 24

TAL

Question 25

What drives Mg reabsorption

Answer 25

Positive lumenal difference

Question 26

What do loop diuretics do for Mg

Answer 26

Strongly inhibit Mg reabsorption and increase excretion

Question 27

What can loop diuretics lead to with Mg

Answer 27

Hypomagnesemia