Pharma (+some nephrogenic DI) Flashcards
What part of the nephron do loop diuretics act on?
How do they work?
Name one
Thick Ascending loop of Henle
Blocks triple transporter
Furosemide
What electrolyte imbalances can occur due to loop diuretics?
Hypo Ca+, K+ and Mg+
Hypokalaemia is the big one
What are the stronger type of diuretics?
Loop
What crystal arthopathy is a contradiction/caution for diuretics?
Gout
What electrolyte state can loop diuretics sometimes be used?
Hypercalemia
Name a thiazide diuretic
Where does it work in the nephron?
Bendroflumethazide
Distal convoluted tubule
What impact does thiazide diuretic have on calcium?
Causes reabsorption of calcium
(opposite to loop)
Big plus for osteoporotic patients
What kind of drug is indapamide?
Thiazide like - currently recommended for HTN management
What drug can be used in nephrogenic DI?
Thiazide diuretics - mechanism poorly understood
Name a potassium sparing diuretic.
How do they work?
Spironolactone
Antagonise aldosterone
Potassium sparing dieuretics are never used alongside other diuretics. T/F?
F
- normally used alongside other diuretics if given alone cause hyperkalaemia
What are the contradictions for potassium sparing diuretics?
Severe renal impairment
Hyperkalaemia
Addison’s disease
Mannitol is an osmotic diuretic. What is the only way it can be given?
How do they work?
IV
They increase the osmotic pressure (increased water) inside the glomerulus ad hence decreases the amount of water reabsorbed (think this is false)
When are osmotic diuretics used?
Acute hypovolaemic renal failure (pre-renal AKI)
(helps to keep the glomerulus full of fluid)
Acutely raised ICP and IOP
(doesn’t enter eye or brain but helps to drain water out of these compartments)
What causes nephrogenic DI?
What bipolar disorder drug is assoc. with the condition?
Inability of the nephron to respond to ADH
Lithium - inhibits the action of ADH
