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BMS 615 Cardiovascular > Test2: Wk7: 5 Diuretics - Rankin > Flashcards

Test2: Wk7: 5 Diuretics - Rankin Flashcards

1
Q

3 uses of diuretics

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

6 Classes of Diuretics

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

Carbonic Anhydrase Inhibitors prototypic drug is

A

acetazolamide

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4
Q

Carbonic Anhydrase Inhibitors MOA

A

inhibit carbonic anhydrase

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5
Q

Carbonic Anhydrase Inhibitors uses

A

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

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6
Q

Carbonic Anhydrase Inhibitors Adverse Effects

A

metabolic acidosis, hypokalemia,

drowsiness, tingling of extremities

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7
Q

Thiazides prototypic agents

A

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

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8
Q

Thiazides related drugs

A

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

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9
Q

Thiazides MOA

A

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

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10
Q

Thiazides urine composition: increase excretion of

A

Na, K, HCO3, H2O

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11
Q

Thiazides urine composition decrease excretion of

A

Ca

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12
Q

Thiazides therapeutic uses (5)

A 
hypertension 
CHF, cirrhosis 
Hypercalciuria 
Nephrogenic Diabetes Insipidus 
Nephrotic Syndrome
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13
Q

Thiazides Adverse Effects (7)

A
  1. Hypokalemia
  2. hypercalcemia
  3. Hyperuricemia
    4Hyperglycemia
  4. Hypovolemia
  5. Hypersensitivity to sulfonamides
  6. increased LDL, cholesterol and TG
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14
Q

most effective diuretics

A

Loop

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15
Q

Loop Dietetics prototypic drugs (4)

A

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

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16
Q

Loop Dietetics MOA

A

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

17
Q

Loop Dietetics effect on urine increase excretion of

A

Na, K, Ca, Cl, H2O

+/- HCO3 Low dose increase HCO3 PO4 High Dose

18
Q

Loop Dietetics effect on urine HCO3

A

+/- low dose

increase HCO3 and PO4 at high doses

19
Q

Loop Dietetics uses (4)

A

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

20
Q

Loop Dietetics Adverse Effects (7)

A

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

21
Q

Potassium Sparing Diuretics drugs (2)

A

spironolactone (Aldactone) and eplerenone (Inspra)

22
Q

Potassium Sparing Diuretics Spirolactone MOA

A

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

23
Q

Potassium Sparing Diuretics urine composition increase excretion of

A

Na, Cl, H2O

24
Q

Potassium Sparing Diuretics urine composition decrease excretion of

A

K, H

25
Q

Potassium Sparing Diuretics - Spironolactone uses

A

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

26
Q

Potassium Sparing Diuretics - Eplerenone uses

A

hypertension

CHF post-MI

27
Q

Potassium Sparing Diuretics adverse effects

A

hyperkalemia

altered hormonal activity

28
Q

Potassium Sparing Diuretics - triameterene and amiloride MOA

A

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

29
Q

Potassium Sparing Diuretics - triameterene and amiloride uses

A

secondary hyperaldosteronism and prevention of hypokalemia

30
Q

Potassium Sparing Diuretics - triameterene and amiloride adverse effects

A

hyperkalemia

31
Q

Osmotic Diuretics drugs

A

Mannitol

32
Q

Mannitol MOA

A

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.

33
Q

Mannitol therapeutic uses

A

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

34
Q

Mannitol adverse effects

A

overexpansion of the extracellular fluid

alteration of Na+, K+ levels in blood

35
Q

K Sparing Triameterene and Amiloride MOA

A

inhibit Na Channels in the late distal tubule and collecting duct

BMS 615 Cardiovascular (49 decks)

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