K+ sparing Diuretics Flashcards

1
Q

what is the site of action of K+ sparing Diuretics ?

A

Collecting Duct

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2
Q

what are the two types of cells found in the collecting ducts ?

A

Principal cells
the main Na+ reabsorbing cells and the site of action of aldosterone, K+-sparing diuretics, and spironolactone.

they secrete K+ through an apical membrane potasium channel.

α-intercalated cells
cells which contain apical H+ ATPase, explaining its ability to secrete protons.

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3
Q

Name the K+ sparing Diuretics

A

Amiloride
(“Almonds”)

Triamterene
(“Tangerines”)

Eplerenone
(“apple with the teacher”)

Spironolactone
(“inspector with spiral bound notebook”)

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4
Q

Aldosterone MOA

A
  • upregulates ENaCs on the apical membrane
  • upregulates Na+/K+ ATPse on the basolateral membrane
  • upregulates K+ channels on the apical membrane
  • upregulates H+ ATPase apical membrane
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5
Q

K+ sparing Diuretics MOA

A

Amiloride , Triamterene

ENaC inhibition

Spironolactone , Eplerenone

Aldosterone receptor antagonists

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6
Q

what are Amiloride and Triamterene used for ?

A

-useful in treatment of Li+ induced nephrogenic Diabetes insipidus
(“inspidus fountain in the background”)

-Amiloride and Triamterene are useful in the treatment of Liddles syndrome (overactive ENaCs)

(“Little midget blocked by tangerines and almonds carts”)

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7
Q

what can Spironolactone and Eplerenone be used for ?

A

-useful in the treatment of primary and secondary Hyperaldosteronism, Conn syndrome, ACTH
(“Crumbling Mineral Mountain in the background”)

  • useful in the treatment of heart failure to prevent K+ wasting
  • prevent myocardial remodeling induced by high level of aldosterone
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8
Q

at higher doses Spironolactone can ..

A

-is a synthetic steroid inhibit Androgen receptors , more specifically 17-alpha Hydroxylase enzyme thus lowers testosterone levels in the body

(“17 alpha-fry-droxylase” “fried male symbol)

  • may treat symptoms of androgen excess in PCOS such as Hirsutism (“bubbling ovary fryers”)​
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9
Q

what are the side effects seen with K+ sparing diuretics therapy ?

A

-can cause mild or even dangerous hyperkalemia
(“Elevated banana’s in stand”)

-may cause a normal anion gap metabolic acidosis
(by decreasing the function of the H+ATPase)

  • K+ sparing diuretics inhibit the effects of aldosterone in the collecting duct causing a **type 4 renal tubular acidosis → **only one associated with hyperkalemia**.
  • **
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10
Q

possible side effects of Spironolactone

A
  • inhibits androgen receptors and 17-alpha hydroxylase enzyme
  • Gynecomastia (“hairy dudismo with lids on chest”)
  • impotence and decreased libido (“Droopy churro”)
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11
Q

What are two classes of diuretics which prevent cardiac remodeling and improve outcomes in heart failure?

A

(1) Aldosterone receptor antagonists

  • Spironolactone
  • ​Eplerenone

(2) ACE Inhibitors

  • Capto , Lisino, Rami , Enala - PRIL
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