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Pharma > Diuretics > Flashcards

Diuretics Flashcards

1
Q

PCT absorption

A

60-70% total reabsorption of Na

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2
Q

Major site for sodium bicarbonate and NaCl reabsorption

AA, glucose, cations, uric acid

A

PCT

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3
Q

Site of SGLT2 inhibitors

A

PCT

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4
Q

4 pumps in PCT

A

1 Na HCO3
2 Na/K ATPase
3 Cl pump (in)
4 Na-Glucose (SGLT2) Co transporter

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5
Q

Inhibits carbonic anhydrase
Promotes NaHCO3 depletion
Enhances NaCl absorption
Dec diuretic effect after several days (water retention)

Examples

A 
Acetazolamide
Methazolamide
Dichlorphenamine
Dorzolamine
Brinzolamine
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6
Q

Well absorbed after oral admin
Inc in urine pH in 30 mins
Dose reduced renal insufficiency

A

Carbonic anhydrase

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7
Q

CA for glaucoma

A

Acetazolamide

Brinzolamide

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8
Q 
For glaucoma
Urinary alkalinization
Metabolic alkalosis
Acute mountain sickness
Sleep apnea
A

CA inhibitors

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9
Q

CA inhibitor toxicity

A 
Hyperchloremic metabolic acidosis
Renal stones
K wasting
Drowsiness
Hypersensitivity
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10
Q

CA I CI in

A

Cirrhosis

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11
Q

Carbonic anhydrase inhibitors act on

A

PCT

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12
Q

Inhibits SGLT2 transporter at PCT
Rapidly absorbed from GIT
Inhibits reabsorption of sugar so they are exrected in urine

A

DapaglifloZin
CanaglifloZin
EmpaglifloZin

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13
Q

SGLT2 flozin CI

A

Severe renal and liver disease

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14
Q

Reduces total exposure of dapaglifloZin by 22%

A

Rifampin

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15
Q

SGLT2 indication

A

DM
dec HbA1C (0.5-1%)
weight loss
drop in systolic BP

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16
Q

SGLT2 toxicity

A

Genital funga infection in women
Hypoglycemia
UTI

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17
Q

Reabsorption of Na (25%), K and Cl via NK2Cl carrier takes place in the

A

Loop of Henle

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18
Q

Major site of Mg and Ca reabsorption

A

LOH

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19
Q

Impermeable to water

A

Thick ascending limb LOH

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20
Q

Transportes in TAL LOH (4)

A

1 NaK2Cl Co transporter
2 Na/K ATPase
3 K/Cl- Co transporter
4 K, Mg, Ca

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21
Q

Inhibits NK2Cl Co transporter

Short acting

A 
Loop diuretics
Furosemide
Bumetanide
Torsemide
Ethacrynic acid
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22
Q

Causes massive NaCl diuresis, K sexcretion at collecting duct

Significant dec in BP

Loss of lumen positive potential

Reduced pulmonary vasculature

A

Loop diuretics

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23
Q

Tx of edematous states in HF, ascites, acute pulmonary edema

Hypertension if TZD inadequate

Severe hypercalcemia

A

Loop diuretics

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24
Q

Loop diuretic SE (4)

A

Hypovolemia
Ototoxicity
Sulfonamide allergy
Hypokalemic metabolic alkalosis

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25
Q

Site of 10% NaCl reabsorption via NaCl Co-transporter (NaCC)
Impermeable to water (more dilute tubular fluid)
Ca reabsorption regulated by PTH

A

Distal convolutee tubule

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26
Q

DCT transporters (5)

A 
1 Na/K ATPase
2 Na-Cl Co transporter
3 Ca pump
4 Na-Ca exchanger
5 Ca-H ATPase
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27
Q

Drugs that act on DCT

A

Thiazide diuretics
HCZ
Chlorothiazide IV
Chlorthalidone

28
Q

Inhibits NCC in early DCT
DOA: 6-12h
Oral route
Synergistic with loop diuretics

A

Thiazide

29
Q

Moderate but sustained NaCl diuresis
Promotes Na-Ca exchange at basolateral membrane (inc Ca reabsorption)
For Nephrogenic Diabetes inspidus

A

Thiazide diuretics

30
Q

Thiazide diuretics SE (7)

A 
Massive sodium diuresis
Hypokalemic metabolic alkalosis
Hyperglycemia
Hyperuricemia
Hyperlipidemia
Sulfonamide allergy
Hypotension
31
Q

Site of reabsorption for 2-5% of NaCl final site

Site of action of aldosterone

A

Collecting tubule and duct

32
Q

Site of potassium secretion and urinary acidification

A

CD and duct

33
Q

Principal cells of CD transport

A

Na, K, Water

34
Q

Intercalated cells of CD facilitate secretion of

A

H (alpha)

HCO3 (beta)

35
Q

Transporter in CD Principal Cell (3)

A

Na/K ATPase
ENaC
K out

36
Q

Transporter at CD Intercalated Cell (2)

A

1 HCO3-Cl exchanger

2 H ATPase pump

37
Q

Aldosterone act on the

A

Principal cells of CD

38
Q

Site of final urine concentration

A

Collecting tubules and collecting duct

39
Q

Regulates insertion of pre formed water channel aquaporin 2 on apical membrane

A

ADH

Vasopressin

40
Q

Loss of ADH in apical membrane of CT makes it

A

impermeable to water

Dilute urine

41
Q

ADH also stimulates insertion of

A

Urea transporter in apical mem

42
Q

Drugs that act on CD

A

K sparing diuretics

43
Q

Blocks intracellular aldosterone receptor

A

Spironolactone

Eplerenone

44
Q

Blocks ENaC

A

Triamterene

Amiloride

45
Q

Inc sodium clearance

Dec potassium and hydrogen excretion

A

K sparing diuretic

46
Q

To counteract K wasting due to thiazide or loop use (Hypokalemia)
Hyperaldosteronism
Heart failure

A

K Sparing diuretic

47
Q

K Sparing diuretic SE

A

Hyperkalemic metabolic acidosis

48
Q

Spironolactone may cause

A

gynecomastia

49
Q

K sparing diuretics should not be given with

A

ACE and ARB

50
Q

activates V2 receptor causing insertion of aquaporin 2 channels in apical membrane

A

ADH agonist

Desmopressin

51
Q

Desmopressin causes (2)

A

Dec urine volume

Inc urine conc

52
Q

Desmopressin if for

A

Diabetes insipidus neurogenic

53
Q

Desmopressin may cause (2)

A

Dilutional hyponatremia

Hypertension

54
Q

Blocks V1 and V2 receptor

A

ADH antagonist
Conivaptan
Demeclocyline
Lithium

55
Q

Selective V2 blocker inhibiting ADH

A

Tolvaptan

56
Q

Conivaptan and Tolvaptan promotes (2)

A

Inc urine volume

Dec urine conc

57
Q

Tonivaptan

Conivaptan indicated for

A

Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

Heart failure

58
Q

ADH antagonists SE

A

Demyelination if with hyponatremia rapid correction

59
Q

Demeclocyline SE

A

Bone and teeth abnormality

60
Q

Lithium SE

A

Nephrogenic DI

61
Q

Conivaptan SE

A

Infusion site reaction

62
Q

Freely filtered at glomerulus but poorly reabsorbed from tubule

A 
Osmotic diuretics
Mannitol
Glycerin
Urea
Isosorbide
63
Q

Osmotic diuretics act at the

A

PCT

64
Q

Osmotic diuretics cause (3)

A

Inc urine volume
Inc excretion of solute
Dec brain volume and ICP, IOP

65
Q

Maintains high urine flow (severe hemolysis, rhabdomyolysis, TLS)
Acute glaucoma
Dec ICP in neuro condition

A

Osmotic diuretic

66
Q

Osmotic diuretic SE (5)

A 
Hypernatremia
Hypovolemia
Pulmonary edema
Headache
N&V

Pharma (26 decks)

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