Diuretics (Renal Drugs)

Question 1

Carbonic Anhydrase Inhibitors:
Drugs
Mechanism
Location
Uses
Adverse Effects or Toxicity

Answer 1

Acetazolamide, dorzolamide
Inhibition of CA (sodium bicarbonate reabsorption)
PCT
Glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness, epilepsy
Hyperchloremic metabolic acidosis, hypokalemia, nephrolithiasis, sulfa allergy, ammonia toxicity

Question 2

Osmotic Diuretics:
Drugs
Mechanism
Location
Uses
Adverse Effects or Toxicity

Answer 2

Mannitol
Increase osmolarity of tubular fluid (no real target)
PCT and TDL
Drug overdose, increased intracranial or intraocular pressure
Hypovolemia, dehydration hypernatremia, hypervolemia, hypernatremia, pulmonary edema

Question 3

Loop Diuretics:
Drugs
Mechanism
Location
Uses
Adverse Effects or Toxicity

Answer 3

Furosemide, ethycrynic acid
Inhibition of NKCC2
TAL
Edemas from CHF, cirrhosis (ascites), nephrotic syndrome; pulmonary edema; hypertension; hypercalcemia
Postural hypotension ototoxicity, hypokalemic metabolic alkalosis, dehydration, sulfa allergy, interstitial nephritis, gout

Question 4

Thiazide and Congener Diuretics:
Drugs
Mechanism
Location
Uses
Adverse Effects or Toxicity

Answer 4

Hydrochlorothiazide, indapamide
Inhibition of NCC
Early DCT
Hypertension, CHF, idiopathic hypercalciuria, nephrogenic diabetes insipidus, osteoporosis, calcium nephrolithiasis
Hypokalemic metabolic alkalosis, hyponatremia, hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia, sulfa allergy

Question 5

Potassium-Sparing Diuretics:
Drugs
Mechanism
Location
Uses
Adverse Effects or Toxicity

Answer 5

Triamterine, amiloride, spironolactone
ENaC, aldosterone receptor
DCT and CCD
Treatment or prevention of hypokalemic states, CHF (all); hyperaldosteronism (S); lithium-induced nephrogenic diabetes insipidus (A)
Hyperkalemia (all); sexual dysfunction, gynecomastia, menstrual irregularities (S)

Question 6

Vasopressin Antagonists:
Drugs
Mechanism
Location
Uses
Adverse Effects or Toxicity

Answer 6

Conivaptan, tolvaptan
Inhibition of vasopressin (ADH) receptor (V2)
MCD
SIADH, chronic euvolemic hyponatremia
Infusion-site reactions (C); nausea, xerostomia (T); postural hypotension, hypokalemia (all)