Drugs to Treat Hypo/Hyperkalemia (Wolff) Flashcards
What factors enhance cell uptake of potassium?
1) Insulin
2) β-Catecholamines
3) Alkalosis
What factors decrease cell uptake of potassium?
1) α-Catecholamines
2) Acidosis
What make up the K+ sparing diuretics?
1) Triamterene
2) Amiloride
3) Spironolactone
What make up the K+ losing diuretics?
1) Thiazides
2) Loop diuretics
What is the general MOA of triamterene and amiloride?
MOA of Spironolactone?
1) Na+ channel blockers
2) Aldosterone antagonist
What is the general MOA of thiazides?
Of loop diuretics?
1) Na+ Cl- cotransporter blockers
2) Na+ K+ 2Cl- cotransporter blockers
What are common clinical reasons for administering diuretics?
1) Essential HTN
2) Edema from kidney failure
Where do the loop diuretics act on?
Where do the thiazide diuretics act on?
Where do the Sodium channel blockers and spironolactone act on?
1) Thick ascending limb of Henle
2) Distal convoluted tubule
3) Collecting duct
Which K+ losing diuretic works in patients with low GFR?
Loop diuretics
What are the loop diuretics?
1) furosemide
2) torsemide
3) bumetanide
4) ethacrynic acid
Why do the loop diuretics (besides ethacrynic acid) and thiazides have a risk of hypersensitivity?
Contains sulfonamide (sulfa allergy)
What is the overall MOA of loop diuretics?
Block the Na+-K+-2Cl- cotransporter in the thick ascending limb
What is the overall MOA of thiazides?
Block the Na-Cl cotransporter in the distal convoluted tubule
What toxicities in regards to ion levels are noted with loop diuretics and thiazides?
1) Hypokalemia
2) Hyponatremia
3) Hypocalcemia
4) Hypomagnesemia
5) Hypochloremic metabolic alkalosis
What is the overall MOA of amiloride?
Blocks epithelial sodium channels (ENaC) in the collecting ducts
What is the clinical application of amiloride?
Counteracts K+ loss induced by other diuretics
What is the overall MOA of spironolactone?
Competitive antagonist of aldosterone receptors in the collecting ducts
Why does spironolactone have slow on and slow off effects?
Because it’s a steroid
What toxicity is noted with amiloride and spironolactone?
Hyperkalemia
What is the mainstay treatment of hypokalemia?
K+ replacement
What can be given as intravenous K+ replacement?
It is usually reserved for?
1) Potassium chloride and potassium acetate if acidosis
2) Severe hypokalemia
What can be given as oral K+ replacement?
1) Potassium chloride
2) Potassium phosphate
3) Potassium bicarbonate
In the emergency treatment of hyperkalemia, what do you give in order to antagonize cardiac effects?
IV calcium
In the emergency treatment of hyperkalemia, what do you give in order to redistribute K+ into cells?
1) Insulin
2) Glucose
3) Albuterol
In the emergency treatment of hyperkalemia, what do you give in order to facilitate K+ elimination?
1) K+ losing diuretic
2) Mineralocorticoid in patients with hypoaldosteronism
