Diuretics Flashcards
Name 6 common nephrotoxic drugs
ACE Inhibitors Penicillins NSAID's Metformin Cyclosporin A Aminglycosides (gentamycin etc)
What 4 drugs are indicated for heart failure?
A- ACE inhibitor (eg Lisinopril)
B- B blocker
C- Candesartan
D- loop & thiazide diuretic, Spironolactone (for its anti-aldosterone effects)
Why is Spironolactone indicated in heart failure?
not for its diuretic effects but for its anti-aldosterone effects
What 5 drugs are indicated in hypertension?
Thiazide diuretics Spironolactone (loop diuretics) ACE Inhib/ARB B blockers
What two drugs are indicated in decompensated liver disease (with regards to oedema)?
Spironolactone
Loop diuretics
What is the mechanism of Loop Diuretics?
Block NKCC2 in the thick ascending limb of loop of henle
Name two loop diuretics
Furosemide
Bumetanide
Name a side effect of Furosemide
ototoxicity
Name a side effect of Bumetanide
Myalgia
Name 4 indications for Loop Diuretics
Oedema
Hypertension
Severe hypercalcaemia
Acute pulmonary oedema
What is the mechanism of action of Thiazide diuretics?
Blocks NaCl transporter (NCCT)
Name 2 positives of thiazide diuretics
better in osteoporosis
less potent
Name 3 side effects of thiazide diuretics
Hypokalaemia
Gout
Erectile Dysfunction
Why are thiazide diuretics better in osteoporosis?
As there is less reuptake of Na, there is less Na in the cell. Therefore leads to more movement of Na into the cell, in place of Ca (therefore more uptake of Ca)
Name 2 ENaC blockers
Amiloride
Triameterene
What is the mechanism of action of Amiloride?
block epithelial Na channel
Usually used alongside K losing diuretics
Name 2 potassium sparing diuretics
Spironolactone (aldosterone antagonist)
Amiloride (ENaC blocker)
Name two side effects of Spironolactone
hyperkalaemia
painful gynaecomastia
What is the best diuretic for primary hyperaldosteronism, ascites, oedema? Or when other drugs havent worked for HTN?
Spironolactone
Name 2 carbonic anhydrase inhibitors
Acetazolamide
Methazolamide
Name 4 indications for Carbonic Anhydrase inhibitors
glaucoma
epilepsy
altitude sickness
diuretics
Name 4 indications for Mannitol
Glaucoma
Cerebral oedema
Kidney failure with low urine output
To increase elimination toxins
Name 2 side effects of Carbonic Anhydrase inhibitors
Metabolic acidosis (due to increased HC03- loss) Risk of renal stones due to increased HCO3- in the urine
Through what mechanism can lithium have a diuretic effect?
inhibits ADH release
