Loop diuretics Flashcards
Loop diuretics - MOA
Act on ascending limb of Henle to inhibit the Na,K,2Cl symporter.
Loop diuretics - effects
Powerful natriuretic.
Kaliuresis.
Increased Mg and Ca excretion.
Vasodilation when adm IV.
Loop diuretics AKA
High-ceiling diuretics
How do the loop diuretics cause kaliuresis?
Increased Na and K exchange in the late distal tubule and collecting ducts.
How do the loop diuretics cause increased Mg and Ca excretion?
Reduced reabsorption in ascending limb of Henle.
Loop diuretics - adverse effects
Hypokalemia, hypocalcemia, hypomagnesemia.
Metabolic alkalosis.
Increased blood glucose and uric acid.
Ototoxicity (tinnitus, ear pain, vertigo, hearing deficits).
Blood cell deficiencies.
Sulfonamide derivatives: hypersensitivity.
Loop diuretics - indications
Very useful for: Cirrhosis, CHF, hypercalcemia, nephrotic syndrome, pulmonary edema, renal impairment.
Useful: HT
Why are loop diuretics so useful for pulmonary edema
They also cause vasodilation
Loop diuretics - 4 drugs
Bumetanide
Furosemide
Torsemide
Ethacrynic acid
Loop diuretics - adm
Orally or IV
Ethancrynic acid - indications and why
When pt are allergic/intolerant to other loop diuretics. Ethancrynic acid is the only loop diuretic that is not a sulfonamide derivative.
Loop diuretic causing more ototoxicity
Ethacrynic acid
Loop diuretics - interactions
All - Decreased diuretic effect by NSAIDs.
Bumetanide, furosemide, torsemide - excessive hypotension with ACE inhibitors.
