Trachte Flashcards
loop diuretics
furosemide
bumetanide
loop diuretics mech
- block Na/K/2Cl transport in ascending limb of loop of Henle
- accounts for 25% Na reabsorption
- dramatically increases Na, K, and H20 EXCRETION
thiazide diuretic
chlorthalidone
hydrochlorathiazide
metalozone
thiazide diuretic mech
- block Na/Cl transport in distal convoluted tubule
- accounts for 8% Na reabsorption
- MILDER increase in Na and K EXCRETION (than loop diuretics)
potassium sparing diuretics
spironolatcone
eplerenone
amiloride
triamterene
potassium sparing diuretics mech
- block ALDO receptors (spironolactone and eplerenone)
- block the Na exchange for K and H (amiloride and triamterene)
- MILD diuretics, primarily prevent excessive K wasting = block exchange of Na/K in collecting tubule
ADH and desmopressin
- increase aquaporin channels in collecting duct
- allows CONCENTRATION OF URINE
osmotic diuretics
mannitol
osmotic diuretic mech
exert osmotic effect in proximal tubule to REDUCE H2O REABSORPTION
SGLT-2 inhibitors
canigliflozin
SGLT-2 inhibitors mech
- reduces glucose reabsorption
carbonic anhydrase inhibitors
acetazolamide
carbonic anhydrase inhibitor mech
- block the reabsorptive processes in proximal tubule
- major utility in glaucoma or excess CSF production or urinary alkalinization
probenicid
sulfinpyrazone
- suppress uric acid reabsorption in gout
microtubule inhibitor in gout
colchicine
- suppress uric acid reabsorption in gout
xanthine oxidase inhibitor
allopurinol
- suppress uric acid reabsorption in gout
therapeutic uses loop diuretics
- pulmonary edema
- other edematous condition
- hyperkalemia
- acute renal failure
- anion overdose (bromide, fluoride, iodide)
loop diuretic effect on urine
- increase NaCl excretion
- increase K excretion
why is some K excreted when trying to rid NaCl?
increased Na in lumen exchanged for K in cortical collecting tubule
therapeutic uses of thiazides
- HTN
- HF
- nephrolithiasis caused by hypercalcemia
- nephrogenic diabetes insipidus
major SE thiazides
- HYPERGLYCEMIA (thiazides bind to SUR on K channel controlling insulin release –> opens channel –> K enters –> hyperpolarizes beta cell –> suppress insulin release)
- hyperuricemia
- hypokalemia
- hyperlipidemia
- hyponatremia
- allergic rxn
aldosterone receptor inhibitors
spironolactone
eplerenone
Na/K/H exchange in cortical collecting duct inhibitors
amiloride
triamterene
therapeutic uses K sparing diuretics
- hyperaldosteronism***
- prevent K wasting caused by other diuretics
SE of K sparing diuretics
- hyperkalemia
- hyperchloremia metabolic acidosis
- gynecomastia (spironolactone)
- acute renal failure
- kidney stones
vasopressin (ADH)/desomopressin used to treat
- diabetes insipidus
- bed wetting
vasopressin (ADH)/desmopressin mech
stimulation G-protein coupled receptors in collecting duct –> recruit aquaporin channels
= water moves by osmosis through aquaporin to the hyperosmolar medullary region of kidney*
osmotic diuretics
mannitol
osmotic diuretic mech
mannitol isn’t reabsorbd in nephron –> osmotic effect –> lumen to retain water
osmotic diuretic uses
reduce body water or reduce intracranial or intraocular pressure
mannitol SE/toxicities
- extracellular volume expansion
- dehydration, hyperkalemia, hypernatremia
- hyponatremia when renal function impaired
SGLT-2 inhibitors effects
- loss of glucose in urine
- reduce blood sugar levels in DM
- weight loss (due to loss of energy/glucose)
- SE: ketoacidosis, URIs, yeast infection, hypoglycemia
treatment of gout
- reduce inflammation with NSAIDS (don’t use ASAs)
- reduce uric acid (allopurinol, probenicid, sulfinpyrazone inhibits WOA –> promotes excretion)
- allopurinol
- colchicine
