L9 Diuretics Flashcards
How does CHF retain water
weak heart, decrease CO, decrease GFR, increase aldosterone, increase Na and water reabsorption,
Osmotic diuretics location
Proximal tubule and descending loop
Filtered thru glomerulus
CA inhibitors site of action
proximal tubule
Not much of an effect
Loop diuretics
Inhibit Na/K/2Cl in thick ascending but secreted in proximal (not filtered).
Causes concentrated urine so that water wont be reabsorbed later on
Thiazides
Block Na/Cl symport in early distal
Secreted into proximal tubule
K sparing
location
Types
Late distal tubule and collecting duct
Aldosterone antagonists
ENaC blockers
Aquaretics
What are they
Location
ADH receptor antagonists
Loate distal tubule and collecting ducts
Osmotic example
Mannitol
CA inhibitor example
Acetazolamide
Diuretic braking phenomenon
Body increases sympathetic response b/c of reduced blood pressure. Symp causes vasoconstriction leading to decreased GFR leading to renin, etc.
CA inhibitors on acid base
Metabolic acidosis (H usually pumped into lumen)
Loop and thiazide on acid base
Reduced ECV: metabolic alkalosis
K sparing on acid base
Metabolic acidosis by inhibiting H secretion
Diuretics and Ca excretion
Osmotic/CA: Increase excretion (Dec reab)
Loop: increase excretion (Dec reabsorb)
Thiazide: Increase REABSORPTION
K Sparing; No effect
Loop diuretics and Ca
Increase CA excretion because block the Na/K/2Cl pump that usually provides a gradient for it to flow thru paracellular
