Term
acetazolomaide
(Class, Mechanism, Effects, Indication, Contraindication, Adverse Effects) |
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Definition
Class: diuretic, carbonic anhydrase inhibitor
Mechanism: carbonic anhydrase inhibitors, acts at lumenal membrane, sulfonamide derivative; increase solute delivery to macula densa --> trigger glomerularfeedback and increases afferent arteriole resistance --> decreased GFR or RBF
Effects: decrease NaHCO3 reabsorption, produces diuresis, increase urinary pH, development of metabolic acidosis, increase K+ excretion
Indication: [weak diuretic]; glaucoma, urinary alkalization, metabolic alkalosis, acute mountain sickness
Contraindication: liver cirrhosis
Adverse Effects: acidosis, renal stones, K+ wasting, "allergy" |
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Term
mannitol
(Class, Mechanism, Effects, Indication, Adverse Effects, Pharmacokinetics) |
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Definition
Class: diuretic, osmotic diuretic
Mechanism: increase osm of plasma and tubular fluid, marked increase in urine flow
Effects: inc osmolality of plasma (initially) and tubular fluid (after filtered); causes water retention in tubular fluid through osmotic forces in prox tubule and via reduced medullary tonicity in loop
Indication: reduce brain volume, decrease intraocular pressure; emergency setting of head trauma/brain hemorrhage/symptomatic cerebral mass; prior to neurological or ophthalmic procedures
Adverse Effects: initial hyponatremia then hypernatremia; pulmonary edema, dehydration
Pharmacokinetics: parenteral admin, pharmacological inert, freely filtered by glomerulus and not reabsorbed |
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Term
furosemide
(Class, Mechanism, Effects, Indication, Adverse Effects, Pharmacokinetics) |
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Definition
Class: diuretic, loop diuretic
Mechanism: NKCC2 inhibitor;
Effects: increase NaCl excretion; decrease lumen-positive potential from K+ recycling; increase Ca++ and Mg++ excretion; increase K+ excretion and H+ excretion
Indication: most efficacious diuretic type; acute pulmonary edema (CHF), nephrotic and liver edema, acute hypercalcemia, hypertension, hyperkalemia, anion overdose (bromide, fluoride, iodide)
Adverse Effects: post-diuretic Na+ retention; hypokalemic metabolic alkalosis, ototoxicity (reversible), hyperuricemia, hypomagnesemia, sulfa-drug allergic rxn, hyponatremia
Pharmacokinetics: short elimination half-life; extensive ppb, secreted in proximal tubule |
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Term
bumetanide
(Class, Mechanism, Effects, Indication, Adverse Effects, Pharmacokinetics) |
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Definition
Class: diuretic, loop diuretic
Mechanism: NKCC2 inhibitor;
Effects: increase NaCl excretion; decrease lumen-positive potential from K+ recycling; increase Ca++ and Mg++ excretion; increase K+ excretion and H+ excretion
Indication: most efficacious diuretic type; acute pulmonary edema (CHF), nephrotic and liver edema, acute hypercalcemia, hypertension, hyperkalemia, anion overdose (bromide, fluoride, iodide)
Adverse Effects: post-diuretic Na+ retention; hypokalemic metabolic alkalosis, ototoxicity (reversible), hyperuricemia, hypomagnesemia, sulfa-drug allergic rxn, hyponatremia
Pharmacokinetics: short elimination half-life; extensive ppb, secreted in proximal tubule |
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Term
torsemide
(Class, Mechanism, Effects, Indication, Adverse Effects, Pharmacokinetics) |
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Definition
Class: diuretic, loop diuretic
Mechanism: NKCC2 inhibitor;
Effects: increase NaCl excretion; decrease lumen-positive potential from K+ recycling; increase Ca++ and Mg++ excretion; increase K+ excretion and H+ excretion
Indication: most efficacious diuretic type; acute pulmonary edema (CHF), nephrotic and liver edema, acute hypercalcemia, hypertension, hyperkalemia, anion overdose (bromide, fluoride, iodide)
Adverse Effects: post-diuretic Na+ retention; hypokalemic metabolic alkalosis, ototoxicity (reversible), hyperuricemia, hypomagnesemia, sulfa-drug allergic rxn, hyponatremia
Pharmacokinetics: short elimination half-life; extensive ppb, secreted in proximal tubule |
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Term
ethacrynic acid
(Class, Mechanism, Effects, Indication, Adverse Effects, Pharmacokinetics) |
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Definition
Class: diuretic, loop diuretic
Mechanism: NKCC2 inhibitor;
Effects: increase NaCl excretion; decrease lumen-positive potential from K+ recycling; increase Ca++ and Mg++ excretion; increase K+ excretion and H+ excretion
Indication: most efficacious diuretic type; acute pulmonary edema (CHF), nephrotic and liver edema, acute hypercalcemia, hypertension, hyperkalemia, anion overdose (bromide, fluoride, iodide)
Adverse Effects: post-diuretic Na+ retention; hypokalemic metabolic alkalosis, ototoxicity (reversible), hyperuricemia, hypomagnesemia, hyponatremia
Pharmacokinetics: short elimination half-life; extensive ppb, secreted in proximal tubule |
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Term
hydrochlorothiazide
(Class, Mechanism, Effects, Indication, Adverse Effects, Pharmacokinetics) |
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Definition
Class: diuretic, distal tube diuretic (thiazide)
Mechanism: NCC inhibitors, moderately effective, act at lumenal membrane,
Effect: increase NaCl excretion, enhance Ca++ reabsorption, increase K+ and H+ excretion
Indications: hypertension (1st line), edema (assoc. w/ heart, liver and renal diseases), nephrogenic diabetes insipidus, nephrolithiasis, ?osteoporosis?
Adverse Effects: hypokalemic metabolic alkalosis, hyperuricemia, hypomagnesemia, hypercalcemia, sulfa-drug allergic rxn, hyponatremia, hyperglycemia, hyperlipidemia
Pharmacokinetics: variable ppb, proximal tubule secretion via organic acid secretory, range of half-lives |
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Term
chlorthalidone
(Class, Mechanism, Effects, Indication, Adverse Effects, Pharmacokinetics) |
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Definition
Class: diuretic, distal tube diuretic (thiazide)
Mechanism: NCC inhibitors, moderately effective, act at lumenal membrane,
Effect: increase NaCl excretion, enhance Ca++ reabsorption, increase K+ and H+ excretion
Indications: hypertension (1st line), edema (assoc. w/ heart, liver and renal diseases), nephrogenic diabetes insipidus, nephrolithiasis, ?osteoporosis?
Adverse Effects: hypokalemic metabolic alkalosis, hyperuricemia, hypomagnesemia, hypercalcemia, sulfa-drug allergic rxn, hyponatremia, hyperglycemia, hyperlipidemia
Pharmacokinetics: variable ppb, proximal tubule secretion via organic acid secretory, range of half-lives |
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Term
metolazone
(Class, Mechanism, Effects, Indication, Adverse Effects, Pharmacokinetics) |
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Definition
Class: diuretic, distal tube diuretic (thiazide)
Mechanism: NCC inhibitors, moderately effective, act at lumenal membrane,
Effect: increase NaCl excretion, enhance Ca++ reabsorption, increase K+ and H+ excretion
Indications: hypertension (1st line), edema (assoc. w/ heart, liver and renal diseases), nephrogenic diabetes insipidus, nephrolithiasis, ?osteoporosis?
Adverse Effects: hypokalemic metabolic alkalosis, hyperuricemia, hypomagnesemia, hypercalcemia, sulfa-drug allergic rxn, hyponatremia, hyperglycemia, hyperlipidemia
Pharmacokinetics: variable ppb, proximal tubule secretion via organic acid secretory, range of half-lives |
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Term
amiloride
(Class, Mechanism, Effects, Indication, Adverse Effects) |
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Definition
Class: diuretic, K+ sparing, Na+ ch. inhibitor
Mechanism: ENaC inhibitor in collecting tubule
Effects: decrease Na+ influx, decrease transepithelial potential difference, decrease K+ and H+ excretion
Indication: [seldom as sole agent, combo w/ loop and distal tubule diuretics]; HTN
Adverse Effects: hyperkalemia (esp. in renal failure, ACE-I, K+ supplements), metabolic acidosis |
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Term
triamterine
(Class, Mechanism, Effects, Indication, Adverse Effects) |
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Definition
Class: diuretic, K+ sparing, Na+ ch. inhibitor
Mechanism: ENaC inhibitor in collecting tubule
Effects: decrease Na+ influx, decrease transepithelial potential difference, decrease K+ and H+ excretion
Indication: [seldom as sole agent, combo w/ loop and distal tubule diuretics]; HTN
Adverse Effects: hyperkalemia (esp. in renal failure, ACE-I, K+ supplements), metabolic acidosis, ACUTE RENAL FAILE, KIDNEY STONES |
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Term
spironolactone (diuretic)
(Class, Mechanism, Effects, Indication, Adverse Effects) |
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Definition
Class: diuretic, K+ sparing, ALD antagonist
Mechanism: antagonize ALD at receptors in collecting duct
Effect: decrease Na+ influx, decrease transepithelial potential difference, decrease K+ and H+ excretion
Indication: [seldom as sole agent, combo w/ loop or distal tubule diuretic]; hyperaldosteronism, mineralcorticoid excess, HEPATIC CIRRHOSIS, HEART FAILURE
Adverse Effects: hyperkalemia (esp. in renal failure, ACE-I, K+ supplements), metabolic acidosis, gynecosmastia, impotence, menstrual irregularities; (activity at prostaglandin and androgen receptors) |
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Term
eplerenone
(Class, Mechanism, Effects, Indication, Adverse Effects) |
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Definition
Class: diuretic, K+ sparing, ALD antagonist
Mechanism: antagonize ALD at receptors in collecting duct
Effect: decrease Na+ influx, decrease transepithelial potential difference, decrease K+ and H+ excretion
Indication: [seldom as sole agent, combo w/ loop or distal tubule diuretic]; hyperaldosteronism, mineralcorticoid excess, HEPATIC CIRRHOSIS, HEART FAILURE
Adverse Effects: hyperkalemia (esp. in renal failure, ACE-I, K+ supplements), metabolic acidosis; (no activity at androgen/prostaglandin receptors); SUPER EXPENSIVE |
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Term
desmopressin
(Class, Mechanism, Effect, Indication, Adverse Effects, Drug Interactions, Pharmacokinetics) |
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Definition
Class: vasopressin agonist
Mechanism: V2 (ADH receptor) selective agonist
Effect: increase insertion of aquaporins collectin tubule membrane, increase retention of water
Indication: central diabetes insipidus, coagulopathy in hemophilia A and von Willebrand's disease
Adverse Effects: hyponatremia, vasoconstriction
Drug interactions: decrease diuresis with lithium and demeclocycline
Pharmacokinetics: longer-half life than endogenous ligand, oral and nasal preps have limited bioavail, |
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Term
conivaptan
(Class, Mechanism, Effects, Indication, Adverse Effect, Drug Interactions) |
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Definition
Class: vasopressin antagonist
Mechanism: V1 and V2 (ADH receptor) antagonist, IV only
Effects: decrease aquaporin presence in collecting tubules, decrease water retention
Indication: ADH excess - CHF or SIADH
Adverse Effects: hypernatremia, nephrogenic diabetes insipidus, renal failure w/ demeclocyline
Drug interactions: lithium and domeclocycline reduce cAMP production by ADH and interfere with actions of cAMP |
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Term
tolvaptan
(Class, Mechanism, Effects, Indication, Adverse Effect, Drug Interactions) |
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Definition
Class: vasopressin antagonist
Mechanism: V2 (ADH receptor) antagonist, ORAL
Effects: decrease aquaporin presence in collecting tubules, decrease water retention
Indication:[USE ONLY WHEN CAN MONITOR SERUM SODIUM]; ADH excess - CHF or SIADH
Adverse Effects: POTENTIAL IRREVERSIBLE LIVER FAILURE; hypernatremia, nephrogenic diabetes insipidus, renal failure w/ demeclocyline
Drug interactions: lithium and domeclocycline reduce cAMP production by ADH and interfere with actions of cAMP |
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Term
demeclocycline
(Class, Mechanism, Effects, Indication, Adverse Effect, Drug Interactions) |
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Definition
Class: vasopressin antagonist
Mechanism: (ADH receptor) antagonist,
Effects: decrease aquaporin presence in collecting tubules, decrease water retention
Indication: ADH excess - CHF or SIADH
Adverse Effects: lots; hypernatremia, nephrogenic diabetes insipidus, renal failure w/ demeclocyline
Drug interactions: lithium and domeclocycline reduce cAMP production by ADH and interfere with actions of cAMP |
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