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Pharm 1 > Diuretics and Antidiuretics > Flashcards

Diuretics and Antidiuretics Flashcards

1
Q

Carbonic anhydrase (CAse) inhibitors

A

Acetazolamide

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2
Q

Acetazolamide

A

Inhibits carbonic anhydrase in PCT

Cause alkaline diuresis

Hpehloei etaoli aidosis

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3
Q

Ciliary body of eye

A

Secrets HCO3- into the aqueous humor (CAse is required)

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4
Q

Choroid plexus

A

Secrets HCO3- into the CSF (CAse is required)

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5
Q

Carbonic anhydrase (CAse) inhibitors Indications

A

Glaucoma
** dorzolamide & brinzolamide **

Acute mountain sickness

Urinary alkalization

Metabolic alkalosis

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6
Q

Carbonic anhydrase (CAse) inhibitors Adverse Effects

A

Hyperchloremic metabolic acidosis

  • Renal stones
  • Hypokalemia

Hypersensitivity reactions

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7
Q

Carbonic anhydrase (CAse) inhibitors Contraindications

A

*hepatic cirrhosis

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8
Q

Loop diuretics (High ceiling diuretics)

A

Furosemide

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9
Q

Furosemide

A

inhibit Na+/K+/2Cl- co-transport in the thick ascending limb of loop of Henle ->
abolition of lumen positive potential

Most efficacious diuretics

*** increase renal blood flow (due to PG synthesis)

↑ loss of Mg++ & Ca++

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10
Q

Loop diuretics (High ceiling diuretics) Indications

A

Acute pulmonary edema

Edema due to acute left ventricular failure

Acute renal failure

Hypercalcemia

Anion overdose

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11
Q

Loop diuretics (High ceiling diuretics) Side Effects

A

Hypokalemic metabolic alkalosis

Ototoxicity

Hyperuricemia

Hypocalcemia

Hypomagnesemia

Allergic reactions (skin rash, eosinophilia, interstitial nephritis)

Other toxicities

  • severe dehydration
  • hyponatremia
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12
Q

Thiazides

A

Hydrochlorothiazide, chlorothiazide

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13
Q

Hydrochlorothiazide, chlorothiazide

A

Block Na+/Cl- co-transport in DCT

↑ Ca++ reabsorption

↑ uric acid level

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14
Q

Thiazides Indications

A

Hypertension

Heart failure

Nephrolithiasis (due to idiopathic hypercalciuria)

Nephrogenic diabetes insipidus

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15
Q

Thiazides Adverse Effects

A

Hypokalemic metabolic alkalosis

Hyperuricemia

Impaired carbohydrate tolerance- *hyperglycemia

*Hyperlipidemia

Allergic reactions- photosensitivity, hemolytic anemia, thrombocytopenia 7.

weakness, fatigability & parasthesia

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16
Q

Potassium sparing diuretics

A

Antagonize the effects of aldosterone at distal and cortical collecting tubule

antagonism: spironolactone & eplerenone

inhibits Na influx: amiloride & triamterene

17
Q

Spironolactone

A

synthetic steroid

competitive antagonist of aldostereone

18
Q

Eplerenone

A

spironolactone analog with greater selectivity for the aldosterone receptor

** used for treatment of HTN

19
Q

Triamterene and amiloride

A

Do not block aldosterone receptor instead they directly interfere with Na+ entry

20
Q

Indications of K+ sparing diuretics

A
  • Mineralocorticoid (aldosterone) excess
  • Hypertension (along with thiazides)
  • Edematous conditions (heart failure, hepatic cirrhosis)
21
Q

Side effects of K+ sparing diuretics

A
  • Hyperkalemia
  • Metabolic acidosis
  • Gynecomastia (only with spironolactone)
22
Q

Osmotic diuretics

A

mannitol

23
Q

mannitol

A

Proximal tubule and descending limb of loop of Henle

NOT ABSORBED ORALLY

↓ intracranial pressure

24
Q

Osmotic diuretics Indications

A

reduce intracranial (in cerebral edema) & intraocular pressure (in glaucoma)

increase urine volume

25
Q

Osmotic diuretics Side effects

A

can complicate heart failure, may produce pulmonary edema (mannitol is contraindicated in pulmonary edema and edema due to heart failure)

dehydration and hypernatremia

26
Q

Vasopressin

A

luminal water channel, AQP2

27
Q

ADH agonists

A

Desmopressin (V2 selective), Vasopressin, Terlipressin, Lypressin

(PRESSIN)

28
Q

ADH antagonists

A

Conivaptan, Tolvaptan Demeclocycline & Lithium

29
Q

V1a receptors

A

blood vessels

vasoconstrictor

GPCR -> IP3/DAG

30
Q

V2 receptors

A

GPCR -> adenylyl cyclase

vasodilator

↑water permeability in distal kidney tubules

31
Q

___ receptors are more sensitive to ADH

A

V2

32
Q

vasopressin on platelet agregation

A

release of coagulation factor VIII & von Willebrand factor (V2 action)

33
Q

V1 receptor uses

A

Bleeding esophageal varices- vasopressin

34
Q

V2 receptor uses

A

Diabetes insipidus (DI)

Hemophilia, von Willebrand disease

35
Q

Vasopressin antagonists (DLC)

A

demeclocyline
lithium
conivaptan

in hyponatremia, used to treat:
liver cirrhosis
SIADH

Pharm 1 (8 decks)

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