Oedma

Question 1

when should drugs to treat oedema be taken?

Answer 1

in the morning to avoid sleep disruption

Question 2

what are examples of drugs to treat oedema?

Answer 2

loops
thiazides
thiazide like diuretic
potassium sparing diuretic
aldosterone antagonists
osmotic diuretic
carbonic anhydrase inhibitors

Question 3

what are examples of LOOPS?

Answer 3

bumetanide (most potent)
furosemide (gout)
torasemide (musculoskeletal pain)

Question 4

what are examples of thiazides?

Answer 4

bendroflumethazide
cyclopenthiazide

Question 5

what are examples of thiazide related diuretics?

Answer 5

chlortalidone (long half life)
indapamide (less aggravation of diabetes)
metolazone (still works in severe renal failure)
xipamide

Question 6

what are examples of potassium- sparing diuretics?

Answer 6

amiloride
triamterene (blue urine in some lights)

Question 7

what are examples of aldosterone antagonists?

Answer 7

spironolactone (ascites liver failure)
eplerenone (use in post- acute myocardial infarction)

Question 8

what is an example of an osmotic diuretic?

Answer 8

mannitol (use in cerebral oedema)

Question 9

what is an example of carbonic anhydrase inhibitor?

Answer 9

acetazolamide (use in glaucoma)

Question 10

how do diuretics work?

Answer 10

diuretics increase urine output by the kidneys i.e promotes diuresis by inhibiting sodium reabsorption at different parts of the renal tubular system (nephron)

Question 11

what is the mechanism of action of loops?

Answer 11

inhibits Na+/ K+/ Cl- co transporter in ascending limb of loop of henle

Question 12

what is the onset and duration like for loops?

Answer 12

onset: 1 hour
duration: 6 hours

Question 13

what are the side effects of loops?

Answer 13

ototoxicity (tinnitus, deafness)
acute urinary retention= too rapid diuresis, caution in benign prostatic hyperplasia

hyperglycaemia (diabetes)

hyperuricaemia (gout- furosemide)

Hypo K+ Na+ Cl- Mg2+ (alcoholic cirrhosis)
Hypo Ca2+

Question 14

how should those with heart failure take furosemide?

Answer 14

BD
Take last dose at 4 pm

20mg- 40mg OM- furosemide doses

Question 15

How should resistant hypertension be treated with loops?

Answer 15

bumetanide (most potent)
torasemide (musculoskeletal pain)
furosemide (gout)

Question 16

what is the mechanism of action of thiazides and related?

Answer 16

inhibits Na+/ Cl- transporter in distal convulated tubule

Question 17

what is the onset and duration of thiazides and related like?

Answer 17

1-2 hour onset
12- 24 hour duration

Question 18

what are side effects of thiazides and related?

Answer 18

GI disturbances
impotence
high LDL/ triglycerides

hyperglycaemia (diabetes)
hyperuricaemia (gout)

Hypo K+ Na+ Cl- Mg2+ (alcoholic cirrhosis)
Hyper Ca2+

INEFFECTIVE IF eGFR<30mL/ min except metolazone

Question 19

what is the dose of thiazides and related in HEART FAILURE?

Answer 19

OM 5mg

Question 20

what is the dose of thiazides and related in HYPERTENSION?

Answer 20

OM 2.5mg
- Bendroflumethiazide doses

indapamide (less diabetes)
metolazone (use in severe renal failure)

chlortalidone (long half life, given on alternative days if acute retention is a problem or dislikes frequent urination)

Question 21

What is the mechanism of action of potassium sparing diuretics?

Answer 21

promotes urination (diuresis)
without the loss of potassium
by inhibiting sodium channels in the distal convoluted tubule

they are weak diuretics used as an adjunct to loop and thiazide diuretics

Question 22

when are potassium sparing diuretics used?

Answer 22

preferred over potassium supplements in counteracting hypOkalaemia

Question 23

what are side effects of potassium sparing diuretics?

Answer 23

hyperkalaemia

Question 24

what are interactions of potassium sparing diuretics

Answer 24

AVOID concomitant ACEi/ ARB, K+ supplements, aldosterone antagonist
as can lead to hypERkalaemia.