Rx Files Diuretics

Question 1

What early diuretic class is no longer used and why?

Answer 1

Mercuric: severe ADRs

Question 2

Osmotic diuretic mechanism of action

Answer 2

prevent reabsorption of sodium and water from the proximal tubules

Question 3

What route is mannitol administered?

Answer 3

IV

Question 4

When might mannitol be used?

Answer 4

reduce ICP

Question 5

How should mannitol always be administered?

Answer 5

in-line filter

Question 6

What are the osmotic diuretics?

Answer 6

• glycerin
• urea
• mannitol

Question 7

What are the aquaretic diuretics?

Answer 7

demeclocycline

Question 8

Aquaretic mechanism of action

Answer 8

interferes with the activity of ADH

Question 9

Carbonic anhydrase inhibitors can cause severe what?

Answer 9

hypokalemia

Question 10

What disease state is the main role of treatment for carbonic anhydrase inhibitors?

Answer 10

glaucoma

Question 11

How can carbonic anhydrase inhibitors effect the excretion of other drug products?

Answer 11

altering blood and urine pH level

Question 12

Carbonic anhydrase inhibitors have potential cross-sensitivity with

Answer 12

sulfonamides

Question 13

What are the carbonic anhydrase inhibitors?

Answer 13

acetazolamide

Question 14

Acetazolamide brand

Answer 14

Diamox

Question 15

What dosage form is acetazolamide available in?

Answer 15

IV and PO

Question 16

Thiazide diuretics mechanism of action

Answer 16

act in the distal tubule to prevent reabsorption of sodium and water

Question 17

Where must thiazides be present in order to exert their effects?

Answer 17

luminal fluid

Question 18

At what CrCl are thiazide’s efficacy questionable?

Answer 18

< 30 mL/min

Question 19

What is the only thiazide with CAI activity?

Answer 19

Chlorothiazide

Question 20

What cross-sensitivity is possible with thiazides?

Answer 20

sulfonamides

Question 21

Tiazide onset of action

Answer 21

1-2 hours

Question 22

What are possible electrolyte imbalances that can occur with thiazide use?

Answer 22

• hypokalemia
• hypomagnesemia
• hyperuricemia
• hyperglycemia
• hypercalcemia

Question 23

What drug concentrations should be monitored closely with concomitant use of thiazides?

Answer 23

Lithium

Question 24

Thiazides should be taken no later than __:___.

Answer 24

5:00 pm

Question 25

What are the thiazide diuretics?

Answer 25

HCTZ

Question 26

What are the loop diuretics?

Answer 26

- ethacrynic acid - furosemide - bumetianide - torsemide

Question 27

1 mg of bumetanide = ____ mg of torsemide = ___ mg of furosemide

Answer 27

1 mg B = 10 - 20 mg T = 40 mg F

Question 28

Loop diuretic mechanism of action

Answer 28

Blocks sodium reabsportion in the ascending loop of Henle

Question 29

Loop diuretic duration of action

Answer 29

6-8 hours

Question 30

(T/F) Only torsemide is available IV.

Answer 30

False, all loop diuretics are available IV

Question 31

What electrolyte imbalances may result from loop diuretic use?

Answer 31

- hypokalemia - hypocalcemia - hyperuricemia - hyperglycemia

Question 32

How would you circumvent loop diuretic resistance?

Answer 32

Add a diuretic with a different MOA 30 min prior to loop diuretic dose

Question 33

Aldosterone antagonist mechanism of action

Answer 33

binds to receptors in distal tubules to stimulate the reabsorption of of sodium/water and conserving of potassium

Question 34

Spironolactone acts only when _______ are present.

Answer 34

mineralocorticoids

Question 35

What is the active metabolite of spironolactone?

Answer 35

canrenone

Question 36

Patients on spironolactone should be closely monitored for __________.

Answer 36

hyperkalemia

Question 37

Describe the condition that may develop due to estrogenic effects.

Answer 37

Reversible and painful gynecomastia may develop. This is directly related to dose and duration of therapy.

Question 38

Spironolactone indications

Answer 38

- HTN - hirsutism - excess aldosterone secretion - cirrhosis

Question 39

Second generation aldosterone antagonist with reduced affinity for estrogen receptors

Answer 39

Eplerenone

Question 40

Eplerenone brand

Answer 40

Inspra

Question 41

What are the nonsteroidal potassium sparing diuretics

Answer 41

- triamterene | - amiloride

Question 42

triamterene brand

Answer 42

Dyrenium

Question 43

amiloride brand

Answer 43

Midamor

Question 44

Triamterene/HCTZ brand

Answer 44

Maxzide | Dyazide

Question 45

Amiloride/HCTZ brand

Answer 45

Moduretic

Question 46

Triamterene patient counseling point

Answer 46

may turn urine a blueish color

Question 47

Thiazide-like diuretic

Answer 47

indapamide

Question 48

Indapamide brand

Answer 48

Lozol

Question 49

Indapamide is potassium (sparing/wasting).

Answer 49

Wasting