Wymore Diuretics Flashcards
Thiazide action
Inhibit NaCl reabsorption in DCT
Increase Ca++ reabsorption?
Sulfonamide
Thiazide drug names
Hydrochlorothiazide
Chlorthalidone
Indapamide
Metolazone
Thiazide clinical uses
Hypertension: best diuretic
Edema: HF and KD
Nephrolithiasis: reduces urinary Ca++
Nephrogenic DI: Induce Na+/volume loss???
Hydrochlorothiazide
Thiazide
Adverse: Hypokalemia, gout
12 hour oral
Sulfonamide
Indapamide
Thiazide
Adverse: Class D for pregnancy
once a day
Sulfonamide
Chlorthalidone
Thiazide
Adverse: hypokalemia
Every 1-2 days
Sulfonamide
Metolazone
Thiazide
Once a day
Loop diuretic information
Most efficacious diuretic
Less chronic effect on reducing blood pressure
Induce renal prostaglandin synthesis (protective)
most sulfonamides
Loop diuretic drug names
Bumetanide
Furosemide
Torsemide
Ethacrynic acid - rare
Loop diuretic Clinical uses
Edema: HF and KD
Hypertension: minimal
Hyperkalemia: increase K+ in urine
Acute renal failure: increase urine flow rate and K+ excretion
Anion OD: prevent bromide, fluoride, iodide reabsorption
Hypercalcemia: Ca++ diuresis
Bumetanide
Loop diuretic
Adverse: Ototoxic (IV), hypersensitivity rxns
5hr oral
1hr IV
Ethacrynic acid
Loop diuretic (not sulfonamide)
Adverse: MOST ototoxic (IV),
7hr oral
2hr IV
Furosemide
Loop diuretic
Adverse: Hypersensitivity, ototoxic(IV)
7hr oral
2hr IV
Torsemide
Loop diuretic
Adverse: Hypersensitivity, Ototoxic (IV)
7hr oral
7hr IV
Potassium-Sparring Diuretics information
Sprinolactone - competitive antagonist to aldosterone receptor
Triamterene and Amiloride - inhibit sodium flux channel
Work in CD
Potassium-Sparring Diuretics Clinical uses
Hypokalemia
Heart failure: spironolactone
Hyperaldosteronism
Potassium-Sparring Diuretics Adverse effects
Hyperkalemia
Hyperchloremic metabolic acidosis
Gynecomastia - Spironolactone (tumorigenic)
Kidney stones - Triamterene
Amiloride
Potassium-Sparring Diuretic
Adverse: Hyperkalemia
Once a day
Spironolactone
Potassium-Sparring Diuretic
Adverse: gynecomastia, tumorigenic, ED, hyperkalemia
Tx: Heart failure
1-2 days
Triamterene
Potassium-Sparring Diuretic
Adverse: Kidney stones, Hyperkalemia
Once a day
Osmotic diuretics
Draw water into the plasma from interstitial & cellular sites
No change in ionic balance
Mannitol & Glycerol
Osmotic Diuretic clinical uses
Increase urine volume: Mannitol
Reduction of Intracranial pressure: Mannitol (15mins)
Reduction of intraocular pressure: Glycerol, Mannitol
Decrease TBW greater than total cation. Reduces intracellular volume
Osmotic Diuretic adverse effects
Heart Failure
N/V
Pulmonary congestion
Edema
Glycerol
Osmotic diuretic
Tx: intraocular pressure (glaucoma)
Adverse: HF, N/V, Pulmonary congestion, edema
1hr oral
Mannitol
Osmotic diuretic
Tx: Intracranial pressure, Intraocular pressure
Adverse: HF, N/V, Pulmonary congestion, edema
7hr IV
Carbonic Anhydrase Inhibitors
In PT block Na+ bicarb reabsorption -> Na+ bicarb diuresis
Significant loss of bicarb may result in hyperchloremic metabolic acidosis
Mild, short-term diuretics
Carbonic Anhydrase Inhibitors clinical uses
Glaucoma: (acetazolamide oral/IV & dorzolamide topical) Decrease rate of aqueous humor formation
Acute Mountain sickness: (acetazolamide) Decrease formation of CSF and lowers pH. Counteract respiratory alkalosis. prophylaxis. Severe with cerebral edema - Acetazolamide + dexamethasone, evacuate
Acetazolamide
Carbonic Anydrase Inhibitor
Acute Mountain sickness: Decrease formation of CSF and lowers pH. Counteract respiratory alkalosis. prophylaxis. Severe with cerebral edema - Acetazolamide + dexamethasone, evacuate
Adverse: No IM due to alkalinic pain, Contraindicated with Liver disease, metabolic acidosis, hyperglycemia
10hr oral
Dorzolamide
Carbonic Anydrase Inhibitor
Glaucoma
8hr Topical
eye stuff
Thiazide
Urinary Excretion of Electrolytes
Calcium -
Potassium ++
Loop Diuretic
Urinary Excretion of Electrolytes
Calcium ++
Potassium ++
Potassium-Sparing Diuretic
Urinary Excretion of Electrolytes
Calcium -
Potassium -
Osmotic Diuretic
Urinary Excretion of Electrolytes
Calcium +
HCO3 +
Potassium +
Carbonic Anhydrase Inhibitors
Urinary Excretion of Electrolytes
Calcium 0 to +
HCO3 +++
Management of Cerebral edema
Osmotic diuretics +
Management of Congestive heart failure
Loop ++
Thiazide +
Potassium-sparing +
Management of Diabetes insipidus
Thiazide ++
Amiloride for lithium induced toxicity ++ (potassium-spar)
Management of Epilepsy (convulsions)
Acetazolamide +
CA(i)
Management of Glaucoma
CAi ++
Osmotic diuretics +
Management of High Altitude sickness
CAi ++
Management of Hyperaldosteronism
Potassium-sparring diuretics
Management of Hypercalcemia
Loop ++
Management of Hypertension
Thiazide ++
Loop +
Potassium-sparing +
Management of Hypokalemia
Potassium-sparring ++
Management of Nephrolithiasis
Thiazide ++
Management of Nephrotic Syndrome
Loop ++
Thiazide +
Potassium-sparring +
Management of Pulmonary edema
Loop ++
Thiazide +
Potassium-sparring +
Management of Renal Impairment
Loop ++
Thiazide +
Osmotic Diuretics +