Renal Drugs Flashcards
Mechanism: Mannitol
Osmotic diuretic:
Increases tubular fluid osmolarity → increase urine flow, decrease intracranial/intraocular pressure
Clinical use: Mannitol
Drug OD
Elevated intracranial/intraocular pressure
Adverse effects: Mannitol
Pulmonary edema
Dehydration
Contraindicated: Anuria, HF
Mechanism: Acetazolamide
Carbonic anhydrase inhibitor:
Causes self-limited NaHCO3 diuresis and decreases total body HCO3- stores
Clinical use: Acetazolamide
Glaucoma
Urinary alkalinization
Metabolic alkalosis
Altitude sickness
Pseudotumor cerebri
Adverse effects: Acetazolamide
Proximal renal tubular acidosis
Paresthesias
NH3 toxicity
Sulfa allergy
Hypokalemia
Mechanism: Loop diuretics
Furosemide
Bumetanide
Torsemide
Sulfonamide loop diuretic:
Inhibit cotransport system (Na+/K+/2Cl-) of thick ascending limb of loop of henle → abolish hypertonicity of medulla, preventing concentration of urine
Stimulate PGE release (vasodilatory effect on afferent arteriole); inhibited by NSAIDs
Increases Ca2+ excretion
Clinical use: Loop diuretics
Furosemide
Bumetanide
Torsemide
Edematous states
Hypertension
Hypercalcemia
Adverse effects: Loop diuretics
Furosemide
Bumetanide
Torsemide
Ototoxicity
Hyperkalemia
Pancreatitis
Hypomagnesemia
Dehydration
Allergy (sulfa)
Metabolic alkalosis
Interstitial nephritis
Mechanism: Ethacrynic acid
Nonsulfonamide inhibitor of cotransport sytem (Na+/K+/2Cl-) of thick ascending limb of loop of Henle
Clinical use: Ethacrynic acid
Diuresis in patients allergic to sulfa drugs
Adverse effects: Ethacrynic acid
Similar to fureosemide, but more ototoxic
Mechanism: Thiazide diuretics
Hydrochlorothiazide
Chlorhtalidone
Metolazone
Inhibit NaCl reabsorption in early DCT → decreasing diluting capacity of nephron
Decreases calcium excretion
Clinical use: Thiazide diuretics
Hydrochlorothiazide
Chlorhtalidone
Metolazone
Hypertension
HF
Idiopathic hypercalciuria
Nephrogenic DI
Osteoporosis
Adverse effects: Thiazide diuretics
Hydrochlorothiazide
Chlorhtalidone
Metolazone
Hypokalemic metabolic alkalosis
Hyponatremia
Hyperglycemia
Hyperlipidemia
Hyperuricemia
Hypercalcemia
Sulfa allergy
Pancreatitis