DIURETICS (m) Flashcards
drugs inducing a state of increased urine flow
DIURETICS
agents that increase urine volume
o managing disorders involving abnormal fluid retention (edema) or treating HPN in which diuretics cause a decrease in blood volume → decrease BP
DIURETICS
increase in renal sodium excretion
Natriuretic
increases in excretion of solute-free water
Aquaretic
→ kidney is damaged by disease
→ loss of protein from plasma
Nephrotic Syndrome
EDEMATOUS STATES
Heart Failure
Hepatic Ascites
Nephrotic Syndrome
Premenstrual Edema
NON-EDEMATOUS STATES
Hypertension
Nephrolithiasis
Hypercalcemia
Diabetes Insipidus
thiazide diuretic
Hypertension
predominant in the epithelial cells of the PCT
CARBONIC ANHYDRASE INHIBITORS
MODE OF ACTION
→ inhibit carbonic anhydrase located intracellularly & on apical membrane of proximal tubular epithelium
Acetazolamide
→ treatment of glaucoma (chronic)
→ prophylaxis of acute mountain sickness
Acetazolamide
TOXICITY
→ renal stones
→ renal potassium wasting
→ drowsiness, paresthesias, hypersensitivity reactions, tinnitus, alteration of taste
Acetazolamide
→ most widely used
→ affect the distal tubule
THIAZIDES
“ceiling diuretic”
THIAZIDES
there is no reabsorption only excretion
THIAZIDES
hypertension
o first-line for treatment of essential hypertension
o not more than 25 mg per day
o can be used as monotherapy
THIAZIDES
ADVERSE EFFECTS
K depletion (most frequent)
THIAZIDES
act most specifically on the ascending thick limb
LOOP DIURETICS
Furosemide
LOOP DIURETICS
→ decrease renal vascular resistance & increase renal blood flow
→ increase prostaglandin synthesis
LOOP DIURETICS
acute pulmonary edema of heart failure
o drug of choice
LOOP DIURETICS
THERAPEUTIC USES
anion overdose
LOOP DIURETICS
ADVERSE EFFECTS
→ ototoxicity in the form of hearing loss or deafness which is reversible particularly when used with aminoglycoside antibiotics
LOOP DIURETICS
major use:
o treatment of hypertension
POTASSIUM-SPARING DIURETICS
act on collecting tubules to inhibit Na reabsorption & K excretion
POTASSIUM-SPARING DIURETICS
Spironolactone
ALDOSTERONE ANTAGONISTS
Eplerenone
ALDOSTERONE ANTAGONISTS
THERAPEUTIC USES
→ diuretic choice in patients with hepatic cirrhosis
→ secondary hyperaldosteronism
→ heart failure
→ prevent hypokalemia
Spironolactone, Eplerenone
rapidly converted to active metabolites (Canrenone,
Canrenoate)
Spironolactone, Eplerenone
direct inhibitors of Na influx in cortical collecting tubules
AMILORIDE & TRIAMTERENE
used to decrease intracranial pressure & to promote prompt removal of renal toxins
OSMOTIC DIURETICS
→ prototype drug
→ have major effect in proximal tubule & descending limb of the
loop of Henle
MANNITOL
T/ F
MANNITOL is administered through IV route
T
Acetazolamide
A. CARBONIC ANHYDRASE INHIBITORS
B. THIAZIDES
C. LOOP DIURETICS
D. POTASSIUM-SPARING DIURETICS
E. OSMOTIC DIURETICS
A
Chlorothiazide
A. CARBONIC ANHYDRASE INHIBITORS
B. THIAZIDES
C. LOOP DIURETICS
D. POTASSIUM-SPARING DIURETICS
E. OSMOTIC DIURETICS
B
Furosemide
A. CARBONIC ANHYDRASE INHIBITORS
B. THIAZIDES
C. LOOP DIURETICS
D. POTASSIUM-SPARING DIURETICS
E. OSMOTIC DIURETICS
C
ALDOSTERONE ANTAGONISTS
A. CARBONIC ANHYDRASE INHIBITORS
B. THIAZIDES
C. LOOP DIURETICS
D. POTASSIUM-SPARING DIURETICS
E. OSMOTIC DIURETICS
D
AMILORIDE
A. CARBONIC ANHYDRASE INHIBITORS
B. THIAZIDES
C. LOOP DIURETICS
D. POTASSIUM-SPARING DIURETICS
E. OSMOTIC DIURETICS
D
TRIAMTERENE
A. CARBONIC ANHYDRASE INHIBITORS
B. THIAZIDES
C. LOOP DIURETICS
D. POTASSIUM-SPARING DIURETICS
E. OSMOTIC DIURETICS
D
MANNITOL
A. CARBONIC ANHYDRASE INHIBITORS
B. THIAZIDES
C. LOOP DIURETICS
D. POTASSIUM-SPARING DIURETICS
E. OSMOTIC DIURETICS
E
