Diuretics Flashcards
Drugs that modify water excretion
Desmopressin
Conivaptan
Mannitol
Site of uric acid transport and osmotic diuretics
Major site for NaCl and NaHCO3 reabsorption
Site of action of Carbonic Anhydrase inhibitors
PCT
Reduces secretion of aqueous humor in glaucoma
Metabolic acidosis increases respiration in mountain sickness
SE: NAGMA, Hep Enceph in Pxs with cirrhosis
Drug, class
Acetazolamide, Carbonic anhydrase inhibitor
ACIDazolamide
Causes of HAGMA
MUDPILES
Methanol Uremia DKA Paraldehyde, Propylene glycol Isoniazid Lactic acid Ethanol, ethylene glycol Salicylates
Causes of NAGMA
HARDUP
Hyperalimentation Acetazolamide RTA Diarrhea Ureteral Diversion Pancreatic Fistula
These drugs decrease the efficacy of Loop diuretics
NSAIDs
Site of action of loop diuretics
Site of Ca and Mg reabsorption
TAL of Loop of Henle
Half life of Furosemide
6 hours
Inhibits Na/K/2Cl transporter in thick ascending limb of loop of henle
Causes powerful diuresis and Ca excretion
Drug for pulmonary edema, hyercalcemia, ARF
SE: dehydration, ototoxicity, sulfa allergy, hypocalcemia, hypomagnesemia, hyperuricemia
Drug, Class
Furosemide, Loop diuretic
Bumetanide, Torsemide, Ethacrynic acid
Drug with synergistic ototoxicity with aminoglycosides
Efficacy decreased by NSAIDs
Drug, Class
Furosemide, Loop diuretic
Loop diuretic toxicities
OH DANG! Ototoxicity Hypokalemia Dehydration Allergy to Sulfa Nephritis Gout
Site of action of thiazide diuretics
Actively pumps Na and Cl via Na/Cl carrier
Site of Ca reabsorption secondary to PTH
DCT
Calcium is also reabsorbed in the DCT due to ___.
PTH
Inhibits Na/Cl transporter in the DCT
Causes modrate diuresis and reduce Ca excretion
Drug for HPN, Nephrogenic DI
SE: HyperGLUC
Drug, Class
Hydrochlorothiazide, Thiazide diuretic
Chlorthalidone, Indapamide, Metolazone
Drug with synergistic effect with loop diuretics
Efficacy is decreased by NSAIDs
HCTZ
Last site for Na reabsorption, K excretion
Under the influence of aldosterone
Primary site for urine acidification
Site of K-sparing diuretics
Cortical Collecting Duct
Potassium sparing diuretics:
SEAT PO Spironolactone Eplerenone Amiloride Triamterene POtassium
Steroid inhibitors of cytoplasmic aldosterone receptor in CCD
Reduces K excretion
Drug for hyperaldosteronism, hypoK, HPN
SE: gynecomastia, hyperK
Drug, Class
Spironolactone, Potassium-Sparing Diuretic (Aldosterone antagonist)
(Eplerenone)
Diuretic that reduces progression of DM nephropathy and reduces mortality post-MI
Drug, Class
Eplerenone, Potassium-Sparing Diuretic
Drug that inhibits ENaC epithelial sodium channels in CCD Reduces Na reabsorption and K excretion Drug for hypokalemia SE: hyperK, ARF, Kidney stones Should NEVER be given with K supplements
Drug, Class
Amiloride, Potassium-Sparing Diuretic
Triamterene
Drugs that cause Gynecomastia
Some Drugs Create Awesome Knockers Spironolactone Digoxin Cimetidine Alcohol Ketoconazole
Drugs that reduce reabsorption of water in the descending limb of the loop of henle and Collecting tubule
Used for increased ICP, acute glaucoma
SE: transient volume expansion
Drug, Class
Mannitol, Osmotic diuretic
Glycerin, Isosorbide, Urea
Site of action of ADH agonists and antagonists
Site of water reabsorption secondary to ADH
Medullary Collecting Duct
Agonist at V1/V2 ADH Receptors
Inserts aquaporins in the collecting tubule
Drug for Central DI
SE: hyponatremia, hypertension
ADH, ADH Agonist
Vasopressin, Desmopressin
Antagonist at V1a, V2 receptors
Drug for SIADH
SE: nephrogenic DI, infusion site reaction
Central Pontine Myelinosis may occur with rapid correction of hyponatremia
Conivaptan, ADH Antagonist
Tolvaptan, Lixivaptan, Demeclocycline, Lithium
Identify the drug:
Increases Urine Na, K, HCO3
Blood pH: Acidosis
Acetazolamide
Identify the drug:
Increases Urine Na, K, Ca, Mg, Cl
Blood pH: Alkalosis
Furosemide
Identify the drug:
Increases Urine Na, K, Cl, Ca
Blood pH: Alkalosis
HCTZ
Identify the drug:
Increases Urine Na (small), Decreases Urine K
Blood pH: Acidosis
Spironolactone
Drugs that modify salt excretion
Acetazolamide Furosemide Thiazides Spironolactone Mannitol
