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Diuretics
Pharm 2 test 2
44
Health Care
Graduate
03/03/2009

Additional Health Care Flashcards

 


 

Cards

Term
Four categories of Diuretics
Definition

1. Loop (high ceiling)

2. Thiazide

3. K-sparing

4. osmotic

 

**5th group = carbonic anhydrase I

(not used as diuretic!!)

Term
carbonic anhydrase inhibitor
Definition
Acetazolamine
Term
Acetazolamine works on what pt of kidney
Definition
PCT
Term

Acetazolamine leads to incr excretion of what?

 

causes?

Definition

bicarb, K

 

alkaline urine -> met acidosis

Term
Uses of Acetazolamide
Definition

RARELY as diuretic

 

More commonly in glaucoma (topically)

and Acute Mt. Sickness

 

Term
SE of carbonic anhydrase I
Definition

teratogenic

sulfa allergy

Term

Thiazide and Thiazide-like diuretics

Definition

HCTZ

Chlorothiazide

Metolazone

Indapamide

Term
PK of Thiazides
Definition

-sulfa derivs

-protein bound

Term
Site of action of thiazides
Definition

DCT

 

**reaches by by active secretion into PCT,

traveling through kidney tubule and reaching

site of action at DCT

Term
MOA thiazides
Definition

inhibit Na/Cl symporter in DCT

 

Na and K are excreted

Term
SE thiazides
Definition

Hypokalemia (met acidosis)

hypomagnesemia

hyperuricemia

hyperglycemia

hyperlipidemia

Term

thiazides used to tx

Definition

HTN, CHF

renal dz

Ca kidney stones

cirrhosis

pulm edema

Term
which thiazide is better for tx of pts w/ impaired kidney fxn?
Definition
metolazone
Term

does HCTZ or indapamide have longer duration of action?

Definition

indapamide

**also has some vasodilating effects =

good for HTN!!!

Term
Loop diuretics
Definition

Furosemide

Torsemide

Bumetanide

Term
MOA Loops
Definition

inhibit Na/K/Cl transporter in

ascending limb LOH

 

****greatest diuresis of all groups

Term
PK loops
Definition

sulfa deriv

high ceiling (prod more diuresis with lger dose)

 

**rapidy diuresis

Term
Loops cause excretion of
Definition
Na, Cl, Ca, Mg
Term
Loops are DOC for what?
Definition
Pulmonary Edema
Term

Uses of loops

Definition

1. Pulm Edema 

2. HF ascites

3. Hypercalcemia, Hyperkalemia

4. when renal impairment is <30ml/min

 

 

Term
AE of loops
Definition

1. HYPOkalemia, calcemia, magnesemia

2.HYPERglycemia, uricemia

3. ototoxicity

4. dehydration

Term
Do not use loops with what other drugs??
Definition
Aminoglycosides d/t ototoxic affects!
Term
Osmotic diuretics
Definition

glycerin

mannitol (IV)

isosorbide

urea

Term
Effects of osmotic diuretics
Definition

1. increased uring volume

2. Na excretion dt accel flow

3. decr brain vol, ICP, IOP (mannitol)

Term
Clincal uses osmotics
Definition

-maintain high urine flow in decr

renal blood flow, and solute overload from hemolysis and rhabdo

 

-glaucoma

 

-neuro cond w/ incr. cerebral edema

 

Term
Glycerine uses
Definition
corneal edema
Term
Urea IV uses
Definition
decr CSF pressure
Term
isosorbide uses orally
Definition

emergency of acute angle-closure glaucoma

Term

2 types of K sparing diuretics

Definition

1. Sodium channel blockers

2. Aldosterone antagonists

Term
Sodium channel blocker K sparing diuretics
Definition

Triamterene

Amiloride

Term
Aldosterone Antag K sparing diuretics
Definition

spironolactone

eplerenone

Term

which Na channel blocking k sparing duiretic

is not metabolized

Definition
amiloride
Term

site of action of k sparing diuretics

Definition
DCT
Term
Triamterine and Amiloride work by
Definition

inhibiting the Na/K pump in DCT

 

SAVE K LOSE Na

Term
Uses of Triamterene and Amiloride
Definition

ADJUNCTS to CHF, HTN, (prevents K wasting)

Hypokalemia

Term
SE of triamterene and amiloride
Definition

Hyperkalemia

 

 

careful if taking with other drugs that incr K

(ACEI)

Term

MOA Spironolactone

Definition

Competitively blocks aldosterone to the receptor in the DCT and Collecting Duct

Term
when do you see effect of spironolactone
Definition
several days after beginning tx
Term
does spironolactone have an active metabolite?
Definition

YES canrenone

Term
Uses of spironolactone
Definition

hypokalemia

hyperaldosteronism (primary)

polycistic ovarian sx and hirsutism

Term
AE spironolactone
Definition

hyperkalemia

gynecomastia

impotence in men

Term
Eplerenone uses
Definition

HTN

post MI HF

Term

AE Eplerenone

Definition

similar to spironolactone

BUT NO ENDOCRINE EFFECTS!!

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