Diuretics (final exam) Flashcards
What are diuretics?
Increase urine flow rate
Increase Na+ excretion
Non-pharmacological diuresis
Diuresis achieved through fluid therapy, NaCl administration, free water administration
Increase GFR
Pharmacological diuresis treats
Generalized edema
Localized edema
Other uses of pharmacological diuresis
Treat hypercalcemia
Promote renal toxin excretion
Classifications of diuretic drugs
Based on mechanism, site of action in kidney Osmotic diuretics Loop diuretics Thiazide diuretics K+ sparing diuretics Carbonic-anhydrase inhibitors
Osmotic diuretic mechanism of action
Filtered at glomerulus and poorly reabsorbed
Act as osmolytes in proximal tubule
Mannitol uses
Cerebral edema
Glaucoma
Mannitol pharmacokinetics
IV administration only
Rapid renal excretion
Mannitol precautions
Use only in euhydrated (normal) patients
Loop diuretics mechanism of action
Inhibits Na+/K+/2Cl- symporter in thick ascending loop of Henle
K+ excretion and H+ secretion
Which group of diuretics is most effective?
Loop diuretics
What is the drug of choice in treating cardiogenic pulmonary edema secondary to congestive heart failure?
Furosemide
Furosemide mechanism of action
Loop diuretic
Na/Cl/K/H+ excretion
Furosemide adverse effects
Acute hypovolemia Hypotension Hypokalemia Hypomagnesemia Systemic metabolic alkalosis
Hydrochlorthiazide mechanism of action
Inhibits Na+/Cl- symporter in distal convoluted tubule
Inhibits K+ and Mg+ reabsorption
Increases Ca+ reabsorption
Hydrochlorthiazide uses
Treat hypertension
Treat calcium nephrolithiasis
Treat symptoms of nephrogenic diabetes insipidus
Adjunct treatment of cardiogenic pulmonary edema secondary to congestive heart failure
Hydrochlorthiazide contraindications
Severe renal disease
Hypercalcemia
Spironolactone mechanism of action
K+ sparing diuretic
Aldosterone receptor antagonist in distal tubule
Retention of K+ and H+
Spironolactone uses
Adjunct edema treatment
Treat hyperaldosteronism
Spironolactone pharmacokinetics
Slow onset of action
Oral administration
Spironolactone adverse effects
Hyperkalemia
System acidosis
Reproductive effects
Acetazolamide mechanism of action
Inhibits H+ exchange in proximal tubule
Lower intraocular pressure by decreasing aqueous humor formation
Acetazolamide uses
Treat open-angle glaucoma
Adjunct diuretic
Weak systemic diuretic effects
Acetazolamide pharmacokinetics
Eliminated via kidneys
Oral administration
