Diuretics Flashcards
What is a natriuretic
Something that increases renal sodium excretion
What is a aquaretic
Something that increases excretion of solute-free water
What do carbonic anhydrase inhibitors do?
Decreases bicarb reabsorption, which decreases intracellular H+ which affects the H gradient for the NEH (Na H antiporter) (decreases absorption of Na)
Where do carbonic anhydrase inhibitors work? What are some examples
Proximal tubule; acetazolamide
What are loop diuretics
Drugs that inhibit the NKCC2 transporter
Where do loop diuretics work
LoH
What is our example of loop diuretics
Furosemide
What are loop diuretics used to treat? What are some side-effects?
First line for systemic edema
Can induce hypokalemic metabolic alkalosis
Increases Ca and Mg excretion
What are thiazides?
Drugs that target the NaCl symporter
Where do thiazide drugs work
Distal tubule
What are thiazides used to treat? What are some side effects?
Hypertension and edema states
Enhances Ca reabsorption which can be used for Ca containing kidney stones
What are potassium sparing diuretics? What are the types?
Diuretics that act in areas of K change by decreasing Na reabsorption and reducing K excretion
Aldosterone antagonist
ENaC blocker
Where do potassium sparing diuretics act
Late DT and CCD
What are our aldosterone antagonists? What class are they
Spironolactone and Eplerenone
Potassium sparing diuretics
What are our ENaC blockers
Amiloride and Triamterene
They are potassium sparing diuretics
Where do osmotic diuretics act
PT and DLoH
What is our main osmotic diuretic
Mannitol
What properties do the osmotic diuretics have
Freely filtered at glomerulus and poorly reabsorbed
What are the effects of osmotic diuretics
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)
What is the general effect of diuretics on K
Increase secretion of K (except K sparing diuretics)
Loop diuretics do what to calcium
Increased excretion of Ca; can be used to treat hypercalcemia
What do thiazide diuretics do for Ca
Stimulate reabsorption in DT through activation of TRPV5
Also used to treat calcium containing kidney stones
What do diuretics do for Pi
Acutely increase Pi excretion (except K sparing diuretics)
Where is Mg primarily reabsorbed
TAL
What drives Mg reabsorption
Positive lumenal difference
What do loop diuretics do for Mg
Strongly inhibit Mg reabsorption and increase excretion
What can loop diuretics lead to with Mg
Hypomagnesemia
