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Pharmacology > Diuretics > Flashcards

Diuretics Flashcards

1
Q

What is anuria?

A

Failure for the kidneys to produce urine

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2
Q

Why are diuretics used for anuria?

A

To help the kidneys make urine

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3
Q

Why are diuretics used during HTN?

A

to decrease blood volume which will decrease BP

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4
Q

What are diuretics used w/ CHF?

A

To decrease the amount of blood that is backing up in lungs or systemically

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5
Q

Why are diuretics used during liver disease?

A

To increase albumin concentration to raise BCOP

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6
Q

Why are diuretics used during glaucoma?

A

To decrease fluid that can increase IOP

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7
Q

What are diuretics used for nephritis?

A

To help the kidney produce urine

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8
Q

Why are diuretics used during encephalopathy?

A

To decrease fluid in brain

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9
Q

How does liver disease cause edema?

A

Live makes albumin, when liver disease is happening no albumin is made and therefore on the venous end of blood return there is no BCOP to bring water back into the veins

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10
Q

Where do osmotic diuretics work?

A

PCT and descending loop of henle

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11
Q

Where do CA inhibitors work?

A

PCT

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12
Q

Where do loop diuretics work?

A

Ascending loop of henle

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13
Q

Where do thiazides work?

A

DCT

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14
Q

Where do K-sparing diuretics work?

A

DCT and Collecting Duct

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15
Q

What are the 7 classes of diuretics?

A 
Osmotic agents
CA inhibitors
Loop diuretics
Thiazides/thiazides-like
Potassium sparing
ADH antagonist
SGLT2 inhibitors
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16
Q

What is another name for loop diuretics?

A

Organic acids

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17
Q

Are ostmotic diuretics filtered, reabsorbed or secreted?

A

Filtered

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18
Q

What is mannitol(Osmitrol)? Route? What doesn’t it cross?

A

Osmotic diuretic

IV

Does not cross membranes, thus why it is given IV

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19
Q

What are the indications for osmotic diuretics?

A

Increased intracranial pressure
Cerebral edema
Glaucoma

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20
Q

What is the MOA of CA inhibitor?

A

CA is what turns HCO3 and H+ into H2CO3 and then into H20 and CO2. Thus bicarbonate isn’t able to be reabsorbed into the blood

Thus bicarbonate is peed out

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21
Q

What is peed out when a pt takes CA inhibitors?

A

Na (and water because it follows the salt)

HCO3

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22
Q

What is acetazolamide(Diamox)? Why is metabolic acidosis a ADR of this?

A

CA inhibitor

Causes metabolic acidosis because the pt is peeing out a lot of HCO3 because it is not getting reabsorbed

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23
Q

Why is CA inhibitor used for glaucoma?

A

Because CA is used to increase aqueous humor which increases IOP

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24
Q

Why is CA Inhibitor used for seizures?

A

Seizures occur when the body is too alkaline. In order to decrease alkaline, HCO3 needs to be peed out

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25
Q

Why is CA inhibitor used for acute man sickness?

A

CA inhibitors increase RR to get of H+ in the form of CO2

26
Q

What is hydrochlorothiazide(esodrix,hydroDIURIL)?

A

Thiazide diuretic

27
Q

What is chlorothiazide(Diuril)?

A

Thiazide diuretic

28
Q

What is metolazone(mykrox, zaroxolyn)?

A

Thiazide-like diuretic

29
Q

What is chlorthalidone(Hydone, thalitone)

A

Thiazide like diuretic

30
Q

What is indapamide(Lozol)?

A

Thiazide like diuretic

31
Q

What is the MOA of thiazide and thiazide-like diuretics? What does it cause?

A

Blocks Na/Cl symporter on apical membrane

Causes Na/Cl/K/H/H2O to be peed out

32
Q

What is the strongest diuretic?

A

Loop diuretics

33
Q

Why can thiazides cause hypercalcemia?

A
  • Because Na/Cl symporter on apical membrane is blocked
  • increased Ca2+ is reabsorbed into blood through Na/Ca antiporter on basilar membrane to increase Na level in renal tubular cell
34
Q

What is the Ca channel that Ca2+ comes thru to be reabsorbed into the blood?

A

TRPV5 channel

35
Q

Why are thiazides indicated for kidney stones?

A

Because they help increase Ca2+ reabsorption instead of Ca2+ getting stuck in renal pelvis

36
Q

What are thiazides indicated for Osteoporosis?

A

Because of the reabsorption increase of Ca2+

37
Q

What are the blood levels of a pt on thiazides?

Na/K/Cl/H+

A 
Hyponatremia
Hypochloremia
Hypokalemia
Hypercalcemia
Alkalosis
38
Q

Why is orthostatic hypotension a ADR of thiazides?

A

Because of the decrease in blood volume/decrease BP

39
Q

Why is hypokalemia a ADR of thiazides?

A

Because of Na/Cl symporter being blocked and pulling K+ into collecting duct

40
Q

Why is hypourecemia a ADR of thiazides(2)?

A

Because the inhibition of Na/Cl symporter inhibits uric acid from being excreted

And

Decrease in blood volume increases the uric acid concentration

41
Q

Why is hyperglycemia a ADR of thiazides?

A

Because a decrease in BP increases the sympathetic system which raises BGL

42
Q

What are the indications for loop diuretics?

A

Severe peripheral edema
Pulmonary edema
Liver cirrhosis
Renal disease

43
Q

What is the MOA of loop diuretics? What does it cause to be secreted?

A

Blocks Na/2Cl/K symporter

Causes H+,K+, Cl-, Na+, Mg2+ and H2O to enter collecting duct

44
Q

What are the lab values of a pt on loop diuretics?

A

Hyponatremia
Hypochloremic alkalosis
Hypokalemia

45
Q

Why is hypotension a ADR of loop diuretics?

A

Because of the decrease in blood volume which causes decrease BP

46
Q

Why is hyperuricemia a ADR of loop diuretics?

A

Because the MOA of loop diuretics blocks uric acid from being secreted into the collecting duct

47
Q

Why is hyperglycemia a ADR of loop diuretics?

A

Because decrease in BP causes and increase in sympathetic system which increase BGL

48
Q

What is ototoxocity?

A

Damaging in ear d/t toxic medication

49
Q

Why is ototoxicity a ADR of loop diuretics?

A

Because there are Na/K/Cl channels in the ears that get blocked

50
Q

What is the indications for K-sparing diuretics?

A

HTN
Edema
Hyperaldosteronism

51
Q

What is the MOA of K-sparing diuretics?

A

It blocks aldosterone receptors to prevent channels being made to allow K+ into the renal tubular cells

52
Q

What are the lab levels of K+ sparing diuretics? K+

A

Hyperkalemia

53
Q

What is gynecomastia?

A

Breast enlargement in males

54
Q

What is xanthene derivatives? What do they do? What is an example of one?

A

Diuretic

Increase blood flow thru dilation do vessels to kidneys and GFR

Caffeine is a diuretic

55
Q

How does ADH antagonist act as a diuretic?

A

Blocks the V-2 receptor on the basal membrane which causes a decrease in the production of aquaporin 2 channels on the apical membrane.

Thus decreasing water reabsorption

56
Q

What values should be monitored when taking diuretics?

A

Electrolyte values
Weight
Vital signs
Serum K+ levels

57
Q

Why should a pt take diuretics in the morning?

A

Because it can interfere w/ sleep…ie getting up to pee at night

58
Q

What are the Sx of hypokalemia? Why does it cause this?

A

Muscle weakness
Constipation
Irregular pulse
Lethargy

A decrease of K+ in body causes hyperpolarization of cells, making it difficult for them to depolarize

59
Q

What K+ supplement is taken for hypokalemia?

A

K-DUR

60
Q

What are food high in K+?

A 
Bananas
Dates
Apricots
Broccoli
Green beans
Legumes
61
Q

What diuretic should you not take K+ supplements?

A

K+ sparing diuretics

62
Q

DM pats taking thiazides or loop diuretics should watch what levels of their body?

A

BGL because they can lead to hyperglycemia

Pharmacology (27 decks)

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