Renal

Question 1

metolazone

Answer 1

Thiazide diuretics
Inhibit NaCl reabsorption in early DCT
Decreasing Ca2+ excretion.

HyperGLUC.

CLINICAL USE Hypertension, HF, idiopathic hypercalciuria,
nephrogenic diabetes insipidus, osteoporosis.
ADVERSE EFFECTS 
Hypokalemic metabolic alkalosis,
hyponatremia, 
hyperGlycemia,
hyperLipidemia, 
hyperUricemia,
hyperCalcemia. Sulfa allergy.

Question 2

Triamterene.

Answer 2

Potassium sparing diuretic:
Spironolactone and eplerenone are competitive
aldosterone receptor antagonists in cortical
collecting tubule. Triamterene and amiloride
act at the same part of the tubule by blocking
Na+ channels in the cortical collecting tubule.
CLINICAL USE Hyperaldosteronism, K+ depletion, HF, hepatic
ascites (spironolactone), nephrogenic DI
(amiloride), antiandrogen.
ADVERSE EFFECTS Hyperkalemia (can lead to arrhythmias),
endocrine effects with spironolactone (eg,
gynecomastia, antiandrogen effects).

Question 3

How do NSAIDs affect loop diuretics

Answer 3

Loop diuretics Stimulate PGE release (vasodilatory effect

on afferent arteriole); inhibited by NSAIDs