Term
| Acetazolamide (Diamox) - mechanism only |
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Definition
| PCT diuretic; Carbonic anhydrase inhibitor; HCO3- loss in urine; urine is alkaline; increase excretion of NaCl and H2O. |
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Term
| Acetazolamide (Diamox) - Tx |
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Definition
| Glaucoma, cysteinuria (increased solubility in alkaline urine), seizures (decreases pH of blood), occasionally liver cirrhosis & renal failure |
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Term
| Acetazolamide (Diamox) - Side Fx |
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Definition
| metabolic acidosis, hyperchloremia, drowsiness, increased sensitivity to thiazides |
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Term
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Definition
| Osmotic diuretic - 10x increase in urine flow; primary site of action is PCT; Prevents H2O from leaving the tubule which results in backflow of cations and more H2O; Inert |
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Term
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Definition
| prophy for ARF with low GFR (i.e trauma, shock); Side FX include volume overload & possible heart failure |
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Term
| Loop Diuretics - mechanism |
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Definition
| inhibit Na-K-2Cl symport; increase renin; maintain GFR; causes increased diuresis with NaCl losses; venodilators; |
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Term
| Loop Diuretics - Tx / Side FX |
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Definition
| Tx - edema, hypercalcemia, washout toxins, prophylaxis for renal failure, HTN in combo; Side Fx - increase BUN, hypokalemia, alkalosis, ototoxicity, drug interactions |
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Term
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Definition
| Loop diuretic; inhibits NaCl resorption; high safety margin; interacts with Warfarin |
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Term
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Definition
| Loop Diuretic; 40x more potent than furosemide; no Warfarin interaction |
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Term
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Definition
| Loop diuretic with long half-life; Once daily dosing |
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Term
| Thiazide diuretics - mechanism |
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Definition
| DCT diuretics; Na/Cl symport inhibition in Na-K- Aldo independent segment, cause natriuresis and diuresis along with other fx. Decrease Ca2+ in urine |
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Term
| Thiazide diuretics - short term fx |
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Definition
| diuresis, hypokalemia, decrease CO and BP |
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Term
| Thiazide diuretics - long term fx |
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Definition
| decrease hypervolemia and direct vasodilation |
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Term
| Thiazide diuretics - side fx |
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Definition
| hyperuricemia (gout risk), hypercholesterolemia, hypercalcemia, hypokalemia, hypo-Mg, other in slide deck |
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Term
| Hydrocholorthiazide (Esidrex) |
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Definition
| Class 1 Thiazide diuretic (use when GFR>40ml/min) short acting; tx HTN, nephrogenic diabetes insipidus |
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Term
| Chlorthialidone (Hygroton) |
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Definition
| Class 1 Thiazide diuretic (use when GFR >40ml/min) long acting |
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Term
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Definition
| Class 1 (use when GFR > 40ml/min) |
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Term
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Definition
| Class II (used when GFR 20-40ml/min); increased potency, tx HTN even with renal insufficiency |
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Term
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Definition
| Class II (used when GRF 20-40ml/min);highly potent; tx HTN, and has direct vasodilatory fx |
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Term
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Definition
| inhibit Na resorption in DCT. Used with HCTZ to normalize K+ |
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Term
| Spironolactone (Aldactone) |
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Definition
| K+ sparing diuretic; aldosterone antagonist, competitive inhibitor |
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Term
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Definition
| K+ sparing diuretic; aldosterone antagonist |
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Term
| Amiloride (Midamor) & Triamterene (Dyrenium) |
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Definition
| K+ sparing diuretic; used with HCTZ; Side fx include hypekalemia and anemia |
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Term
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Definition
| acts on 2 receptors- V1- vasopressor (via IP3 and Ca2+release) , V2 - activates aquaporin to increase H2O readsorption |
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Term
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Definition
| Anti-diuretic; V2 receptor agonist, tx central diabetes insipidus and bleeding |
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Term
| Demeclocyline (Declocylcin) |
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Definition
| Anti-ADH, pro-diuretic; use with OPC-31260; antagonize ADH at V2 receptors; Tx Sydrome of inappropriate ADH Secretion |
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Term
| How to manage diuertic induced metabolic alkalosis (a) in patients w/o heart failure and (b) in patients w/ heart failure |
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Definition
| (a) K+ replacement and restoration of volume with NS. (b) NS is contraindicated in these patients, tx with actezolamide |
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Term
| Serious toxicity of diuretic use in cardiac patients and how to manage |
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Definition
| Hypokalemia; manage by reducing Na+ intake to decrease Na+ delivery to the K+ secreting collecting tubule; non compliant patients must take oral KCl or a K+ sparing diuretic |
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