Diuretics Flashcards
Thiazide diuretics include
Hydrochlorothiazide
Metolazide
Chloralidone
Indications for thiazide diuretics
Hypertension
Edema
Loop diuretics include
Furosemide
Torsemide
Bumetanide
Ethacrynic acid
Indications for loop diuretics
Edema
Hypertension
K sparing diuretics
Na channel blockers - amiloride and triaterene
Aldosterone antagonists - spironolactone and eplerenone
Indications for k sparing drugs
Edema and hypertension
Aquaretics
Conivaptan
Tolvaptan
Indications for aquareteicis
Hyponatremia
Carbonic anyhydrase inhibitors
Acetazolamide
Indications for ca inhibitors
Urinary alkalinzation
Mountain sickness
Glaucoma
Osmotic diuretics
Mannitol
K sparing diuretics
Na channel blockers - triamterene, amiloride
Aldosterone antagonists - spironolactone
K wasting diuretics
Thiazides (Na Cl blockers)
Loop diuretics (nkcc cotransporter)
Carbonic anhydrase inhibitors
Osmotic diuretics (nonresorbable solutes)
Mechanism of action of loop diuretics
Block na k 2cl cotransporter in TAL
Potassium diffuses into lumen and blocks Ca and Mg pericellular tranport
At maximum doses, what does furosemide do
Max doses - dissipation of medullary interstitial gradient IRRESPECTIVE of whether urine was dilute or concentrate
ISOTONIC
Indications for loop diuretics
Rapid and massive fluid removal
Edema, hepatic, cardiac or renal origin
Acute pulmonary edema 0 removes excess extracellular fluid
Hypertension that is unresponsive to other diuretics
Works when RBF and GFR are low
AE of loop diureticds
Hyponatremia Hypochloremia Hypokalemia - k wasting diuretic Hypocalcemia Hypotension Hypomagnesium OTOTOXICITY Hyperglycemia, hyperurecemia Hyperlipdemia Crosses placenta
Why do k wasting diuretics cause hypokalemia
Na not reabsorbed in talh is partially reabsorbed by downstream na cl cotransporter via na k exchange in collection
K/H exchange at cells to try to maintain plasma k —> hypochloremic metabolic alkalosis
Drug interactions with loop diuretics
Digoxin
Ototoxic drugs
Potassium sparing diuretics
MoA of thiazide diuretics
Block NaCl cotransporter in DCT
SEVERE magnesium wasting
Thiazides are used in the tx of what type of diabetes insidious
Nephrogenic
Main uses of thiazides
Primary hypertension and edema
Nephrogenic diabetes insipidus
Decreases Ca excretion - can decrease risk of kidney stones
AE of thiazides
Hypokalemia K sparing diuretic Hypochloremic metabolic alkalosis Hypomagnesia Increases plasma glucose, urate, lipid Avoid in pregnancy
