Test2: Wk7: 5 Diuretics - Rankin

Question 1

3 uses of diuretics

Answer 1

1. mobilize fluid
2. excrete fluid (edema, extracellular fluid)
3. excrete electrolytes

Question 2

6 Classes of Diuretics

Answer 2

1. carbonic anhydrase inhibitors
   * 2. thiazides and related agents
   * 3. loop diuretics
   * 4. potassium-sparing diuretics
2. osmotic diuretics
3. miscellaneous (xanthines, ethanol)

Question 3

Carbonic Anhydrase Inhibitors prototypic drug is

Answer 3

acetazolamide

Question 4

Carbonic Anhydrase Inhibitors MOA

Answer 4

inhibit carbonic anhydrase

Question 5

Carbonic Anhydrase Inhibitors uses

Answer 5

open angle glaucoma
prophylaxis of acute mountain sickness
not normally used as diuretic

Question 6

Carbonic Anhydrase Inhibitors Adverse Effects

Answer 6

metabolic acidosis, hypokalemia,

drowsiness, tingling of extremities

Question 7

Thiazides prototypic agents

Answer 7

chlorothiazide (Diuril)
hydrochlorothiazide (Hydrodiuril, others)
polythiazide (Renese)

Question 8

Thiazides related drugs

Answer 8

chlorthalidone (Hygroton)
metalozone (Diulo)
indapamide (Lozol)

Question 9

Thiazides MOA

Answer 9

inhibition of sodium-chloride cotransporter on the luminal membrane of distal tubular cells

Question 10

Thiazides urine composition: increase excretion of

Answer 10

Na, K, HCO3, H2O

Question 11

Thiazides urine composition decrease excretion of

Answer 11

Ca

Question 12

Thiazides therapeutic uses (5)

Answer 12

hypertension 
CHF, cirrhosis 
Hypercalciuria 
Nephrogenic Diabetes Insipidus 
Nephrotic Syndrome

Question 13

Thiazides Adverse Effects (7)

Answer 13

1. Hypokalemia
2. hypercalcemia
3. Hyperuricemia
   4Hyperglycemia
4. Hypovolemia
5. Hypersensitivity to sulfonamides
6. increased LDL, cholesterol and TG

Question 14

most effective diuretics

Answer 14

Loop

Question 15

Loop Dietetics prototypic drugs (4)

Answer 15

Furosemide (Lasix)
Bumetanide (Bumex)
Torsemide (Demodex)
Ethracrynic Acid (Edecrin)

Question 16

Loop Dietetics MOA

Answer 16

inhibit Na-K-2Cl cotransporter in the luminal membrane of ascending limb

Question 17

Loop Dietetics effect on urine increase excretion of

Answer 17

Na, K, Ca, Cl, H2O

+/- HCO3 Low dose increase HCO3 PO4 High Dose

Question 18

Loop Dietetics effect on urine HCO3

Answer 18

+/- low dose

increase HCO3 and PO4 at high doses

Question 19

Loop Dietetics uses (4)

Answer 19

acute pulmonary edema
edema of cardiac, haptic, or renal region
hypertension
hypercalcemia

Question 20

Loop Dietetics Adverse Effects (7)

Answer 20

a. fluid and electrolyte disturbances
1. hypovolemia
2. hypokalemia (hypokalemic alkalosis)
3. hyponatremia
4. hyperuricemia  gout
5. hyperglycemia
6. Ototoxicity
7. Increase LDL, Cholesterol, and TG

Question 21

Potassium Sparing Diuretics drugs (2)

Answer 21

spironolactone (Aldactone) and eplerenone (Inspra)

Question 22

Potassium Sparing Diuretics Spirolactone MOA

Answer 22

competitively inhibits the binding of aldosterone to the mineralocorticoid receptor in late distal tubule and collecting duct cells.

Question 23

Potassium Sparing Diuretics urine composition increase excretion of

Answer 23

Na, Cl, H2O

Question 24

Potassium Sparing Diuretics urine composition decrease excretion of

Answer 24

K, H

Question 25

Potassium Sparing Diuretics - Spironolactone uses

Answer 25

primary hyperaldosteronism prevent hypokalemia caused by thiazide or loop diuretics hepatic cirrhosis

Question 26

Potassium Sparing Diuretics - Eplerenone uses

Answer 26

hypertension | CHF post-MI

Question 27

Potassium Sparing Diuretics adverse effects

Answer 27

hyperkalemia | altered hormonal activity

Question 28

Potassium Sparing Diuretics - triameterene and amiloride MOA

Answer 28

inhibit luminal Na+ channel in late distal tubule and collecting duct. Inhibition may be competitive or noncompetitive

Question 29

Potassium Sparing Diuretics - triameterene and amiloride uses

Answer 29

secondary hyperaldosteronism and prevention of hypokalemia

Question 30

Potassium Sparing Diuretics - triameterene and amiloride adverse effects

Answer 30

hyperkalemia

Question 31

Osmotic Diuretics drugs

Answer 31

Mannitol

Question 32

Mannitol MOA

Answer 32

freely filtered at the glomerulus, but poorly reabsorbed from the luminal fluid. As they are excreted in the urine, water associated with the drug provides the diuresis.

Question 33

Mannitol therapeutic uses

Answer 33

maintain urine flow oliguric acute renal failure reduce intracranial or intraocular pressure not useful for mobilizing edema

Question 34

Mannitol adverse effects

Answer 34

overexpansion of the extracellular fluid | alteration of Na+, K+ levels in blood

Question 35

K Sparing Triameterene and Amiloride MOA

Answer 35

inhibit Na Channels in the late distal tubule and collecting duct