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ESA4 - Clinical Pharmacology > Diuretics > Flashcards

Diuretics Flashcards

1
Q

What is diuresis?

A

Loss of water

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2
Q

What is natriuresis?

A

Loss of sodium

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3
Q

When are carbonic anhydrase inhibitors used?

A

Treatment of glaucoma, mountain sickness

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4
Q

Give an example of a carbonic anhydrase inhibitor

A

Acetazolamide

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5
Q

What are the ADRs of carbonic anhydrase inhibitors?

A

Metabolic acidosis, hypokalaemia

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6
Q

Give an example of an osmotic diuretic

A

Mannitol

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7
Q

What is a common use of mannitol?

A

Used to reduce raised ICP

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8
Q

Give an example of a loop diuretic

A

Furosemide

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9
Q

What channel do loop diuretics act on?

A

NKCC2 in the thick ascending limb

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10
Q

Describe the mechanism of action of furosemide

A

Inhibits NKCC2 in the TAL, blocks Na, K and Cl reabsorption (lost in urine)

Also prevent generation hypertonic renal medulla through inhibiting Mg and Ca reabsorption - increases urine production

Also increase production of prostaglandins - cause vasodilation and increased blood supply to the kidney

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11
Q

What are the main uses of loop diuretics?

A

Heart failure
Decompensated liver disease
Nephrotic syndrome
(Hypertension - used in more advanced kidney disease)

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12
Q

What are the common ADRs of loop diuretics?

A

Hypokalaemia, hyponatraemia

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13
Q

Where do thiazides act?

A

Inhibit the NaCl symporter in the DCT

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14
Q

What is the effect of thiazides on calcium reabsorption?

A

Increases Ca2+ reabsorption in DCT

By lowering the sodium concentration in the tubule epithelial cells, thiazides indirectly increase the activity of the basolateral Na+/Ca2+ antiporter

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15
Q

What are the ADRs of thiazide diuretics?

A

Hypokalaemia
Hypercalcaemia
Hyperuricaemia

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16
Q

Give an example of an aldosterone antagonist

A

Spironolactone

17
Q

What are thiazides used for?

A

Hypertension (vasodilation as well as diuresis)

18
Q

What channel does aldosterone increase the expression of and where?

A

ENaC and Na/K/ATPase in principal cells of collecting duct

19
Q

What is the mechanism of action of aldosterone antagonists?

A

Inhibits Na reabsorption in the collecting duct

20
Q

What are some common ADRs of spironolactone?

A

Hyperkalaemia, impotence, painful gynaecomastia

ESA4 - Clinical Pharmacology (20 decks)

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