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Drugs Lists > Diuretics > Flashcards

Diuretics Flashcards

1
Q

What diuretic can be used to treat kidney stones?

A

Thiazide like diuretics as they increase calcium reabsorption and so decrease urinary calcium

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2
Q

What diuretics are GFR dependent?

A

Thiazide and Loop- larger dose required in patients with reduced GFR

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3
Q

Why may oral furosemide work less effectively in oedematous patients?

A

Bioavailability may decrease as gut oedema may impair absorption of the drug

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4
Q

What diuretic class is indicated in the treatment of resistant hypertension?

A

K+ sparing diuretics. Spironolactone is an aldosterone receptor antagonist in the distal convoluted tubule which inhibits Na+ channel expression

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5
Q

What diuretic can be used to treat metabolic alkalosis?

A

Acetazolamide- a carbonic anhydrase inhibitor that reduces HCO3 absorption

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6
Q

What are the main metabolic effects of Thiazide diuretics?

A

HyperGLUC (pneumonic)-

  1. HyperGlycaemia (contraindicated in diabetics)
  2. HyperLipidaemia
  3. HyperUricaemia
  4. HyperCalaemia (increased Ca2+ reabsorption which is good for osteoporosis and in the prevention of kidney stones
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7
Q

Where do thiazide diuretics act?

A

NaCl cotransporters in the early distal tubule

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8
Q

What diuretics cause acidosis?

A

K+ sparing and carbonic anydrase inhibitors

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9
Q

What diuretics cause alkalosis?

A

Loop and Thiazide like diuretics

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10
Q

Where do loop diuretics act?

A

Inhibit the NaK2Cl transporter in thick ascending loop

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11
Q

Which two diuretics have an effect on serum calcium and what effect do they have?

A

Loop diuretics decrease serum calcium. Thiazide like diuretics increase serum calcium.

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12
Q

what is the only diuretic class to increase serum K+?

A

K+ sparing diuretics. All others decrease serum K+

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13
Q

Where do K+ sparing diuretics act?

A

Distal convoluted tubule (aldosterone receptor antagonist reducing Na+ channel expression- resistant hypertension treatment) and proximal collecting duct on epithelial Na+ channels. Spironolactone in the distal convoluted and amiloride in the collecting duct

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14
Q

Where do osmotic diuretics act? (mannitol)

A

Act everywhere but mainly proximal tubule and descending loop

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15
Q

Indication for osmotic diuretics?

A

To reduce intracranial or intraocular pressure

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16
Q

Where do carbonic anhydrase inhibitors act?

A

Proximal convoluted tubule

17
Q

How do carbonic anhydrase inhibitors work?

A

Eliminate Bicarbonate and have a minor diuretic effect leading to metabolic acidosis and alkalinisation of urine. Can treat glaucoma, alkalosis and altitude sickness

18
Q

Name a carbonic anhydrase inhibitor?

A

Acetazolamide

19
Q

Name some Loop diuretics?

A

Furosemide, bumetanide

20
Q

Name some thiazide like diuretics?

A

Hydrochlorothiazide, metolazone

21
Q

Name some K+ sparing diuretics?

A

Aldosterone receptor antagonist-Spironolactone

Epithelial Channel Blocker- Amiloride

22
Q

A patient requires a thiazide like diuretic to prevent the recurrence of kidney stones. How to do you prevent them from become hypokalaemic?

A

Co prescribe a K+ sparing diuretic

23
Q

Thiazide side effects?

A 
Hypokalaemia and metabolic alkalosis 
HyperGLUC- Glycaemia (caution in diabetes)
                       Lipidaemia
                       Uricaemia
                       Calcaemia
24
Q

Thiazide indications?

A

Hypertension
Oedema (chronic)
Calcium stone prevantion
Osteoporosis

25
Q

Thiazide interactions?

A

Ace Inhibitors
NSAIDS
Glucocorticoids

26
Q

Loop diuretics calcium effect?

A

Cause Ca2+ loss (LOOPS LOSE CALCIUM)

27
Q

Loop side effects?

A

Hypocalcaemia, hypomagnesaemia, alkalosis, hyperuricaemia (gout), hyperglycaemia

“GO PANDA” Gout, Ototoxicity, low Potassium, allergy, Nephritis, dehydration, Alkalosis

28
Q

Loop Indictions?

A

Hypertension, oedema, renal failure, hypercalcaemia, Forced diuresis to clear kidney of toxic substances

29
Q

K+ Sparing side effects?

A

Hyperkalaemia, metabolic acidosis, GI upset. Spironolactone can cause amenorrhoea and gynaecomastia/erectile dysfunction

30
Q

K+ Sparing indications?

A

Hypertension (especially with hypokalaemia)

ascites/oedema

31
Q

Osmotic diuretics contraindictions?

A

progressive heart failure or severe pulmonary oedema

32
Q

Carbonic Anhydrase Inhibitors Ph effect?

A

Cause acidosis- (ACetazolamide causes ACidosis)

Drugs Lists (14 decks)

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