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Clinical Pharmacology > Diuretics > Flashcards

Diuretics Flashcards

1
Q

What channels do loop diuretics block

A

NKCC2 channels in the loop of henle

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2
Q

Give an example of a loop diuretic

A

Fruesmide

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3
Q

What affect on calcium do loop diuretics have

A

Cause hypocalcaemia

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4
Q

What are the ADRs for loop diuretics

A

Ototoxcity, alkalosis, gout, increased LDL

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5
Q

What affect on potassium do loop diuretics have

A

Hypokalaemia as the salt and water not absorbed here is moved to the collecting duct which is absorbed by ENaC which is linked to a ROMK channel so more K is lost

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6
Q

What channels do thiazides block

A

NCCT channels in the DCT

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7
Q

What are thiazides used to treat

A

Hypertension as they are also vasodilators

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8
Q

What are the ADRs for thiazides

A

Gout, hyperglycaemia, increased LDL

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9
Q

What do thiazides do to calcium leaves

A

Gives hypercalcaemia

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10
Q

What do thiazides do for potassium levels

A

Hypokalaemia

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11
Q

What channels do amiloride block

A

ENaC in collecting duct

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12
Q

When do you use amiloride

A

When a patient with hypokalaemia needs a diuretic

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13
Q

What does amiloride do to potassium levels

A

Hyperkalaemia

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14
Q

How does spironolactone work

A

Aldosterone antagonist

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15
Q

What does aldosterone do

A

Inserts more ENaC into the collecting duct - therefore, more salt and water reabsorbed
Speeds up the Na/K/ATPase so more potassium is pumped out of the cells into the blood

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16
Q

When is spironolactone used

A

Heart failure, hypertension and hyperaldosteronism

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17
Q

What does spironolactone do to the potassium levels

A

Hyperkalemia

18
Q

Give an example of an ADH antagonist

A

Lithium

19
Q

What do ADH antagonists do

A

Inhibits the actions of ADH so you lose water only

20
Q

True or false; ADH antagonists give diuresis and naturesis

A

False - only diuresis

21
Q

When do you use ADH antagonists

A

When the patient is hyponatreamic

22
Q

When are carbonic anhydrase diuretics used

A

Glaucoma

23
Q

What happens to the acid base balance when using carbonic anhydrase

A

Lose bicarb giving acidosis

24
Q

What are osmotic agents used for

A

Swelling in the brain

25
Q

What are some general adverse drug reactions of diuretics

A

Anaphylaxis, hypovoleamia, hypotension, electrolyte disturbance, metabolic Abnormalities

26
Q

What are the major cause of hyperkalaemia

A

Reduced urine production

Increased tissue damage

27
Q

What are the effects of hyperkalaemia

A

Cardiac arrhythmias

28
Q

How do you treat cardiac arrhythmias due to hyperkalameia

A
  1. Calcium gluconate - protect the heart
  2. Dextrose/insulin - lowers serum K
  3. Calcium resonium - removes K
29
Q

How doe NSAIDs harm the kidneys

A

Inhibit the production of prostaglandins which cause vasodilation on the afferent arteriole - therefore, if this cant dilate then the GFR will drop further

30
Q

How do ACE inhibitors affect the kidneys

A

Inhibit vasoconstriction of efferent arteriole so allows a further drop in GFR

31
Q

Give some reasons for diuretic resistance

A
  1. swelling in the gut - cant absorb drugs
  2. heart failure - cant pump enough blood to kidneys
  3. Liver problems - drugs cant be transported with albumin
  4. Kidney problems
  5. Salt - lose the effect of the diuretic as the water will follow the salt
32
Q

How does alcohol work as a diuretic

A

Inhibits ADH release

33
Q

How does caffeine work as a diuretic

A

Increases GFR and reduces Na reabsorption

34
Q

Which diuretics work in the PCT

A

Carbonic anhydrase inhibitors

Osmotic diuretics

35
Q

Which diuretics work in the loop of henle

A

Loop diuretics

36
Q

Which diuretics work in the DCT

A

Thiazides

37
Q

Which diuretics work in the CD

A

Spironolactone
Amiloride
ADH antagonists

38
Q

What diuretics are used for liver disease

A

Spironolactone

Loop diuretics

39
Q

What diuretics are used for nephrotic syndrome

A

Loop diuretics in high doses

40
Q

What diuretics are used for oedema

A

Loop diuretics

41
Q

What diuretics are used in hypertension

A
  1. Thiazide

Possibly spironolactone also

42
Q

What diuretics are used for heart failure

A

Loop diuretics

Clinical Pharmacology (18 decks)

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