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Thiazides have what mechanism of action?
They block the passive reabsorption of Na+ and Cl- out of the distal tubule
Hypokalemia causes what four things?
- 1. Arrthymias
- 2. Muscle Weakness
- 3. Depressed breathing
- 4. Muscle Alkalosis
What are the two Thiazide Drugs?
- 1. Hydrocholothiazide
- 2. Trichloromethiazide
What are the uses for Thiazides? (3)
- 1. Lower BP
- 2. Manage edema in congestive heart failure
- 3. Manage edmea in renal or hepatic disease
Thiazides can increase urine production up to what?
Thiazides will decrease what ion secretion?
Thiazides will increase the excretion of what ions?
K+, Na+, Cl-, H+ and Mg
What are the disadvantages of using Thiazides? (4)
- 1. Hypokalemia
- 2. Hypokalemic metabolic alkalosis
- 3. Reduced uric acid excretion
- 4. Reduced insulin secretion (hyperglycemia)
Increase in Uric acid will cause what?
- 1. Gout
- 2. Kidney Stones
- 3. Increase in Glucose ( by decrease in insulin production)
What are the two high ceiling or loop diuretics?
- 1. Furosemide
- 2. Ethycrinic Acid
What are the uses of loop diuretics? (3)
- 1. Hypervolemia
- 2. Hypercalcima
- 3. Any Pathological accumulation of non-inflamatory fluid
What are the disadvantages of loop diuretics that are not the same disadvantges as Thiazides? (2)
- 1. Dehydration
- 2. Hypocalemia
What is the mechanism of action of loop diuretics?
They block the passive reabsorbtion of Na+, K+ and Cl- in the ascending loop of henle
High Celing drugs can maximally increase urine up to what production?
What are the uses of Potassium Sparing Drugs? (7)
- 1. To correct K+ imbalances created by other K+ wasting diuretics
- 2. Refractory edema
- 3. Primary Aldosteronism
- 4. Hypokalema
- 5. Hepatic Cirrohis
- 6. Congesive Heart failure
- 7. Renin dependent hypertension
What are the advantages of potassium sparing drugs? (2)
- 1. No hypokalemia
- 2. Can be used with K+ wasting drugs to prevent K+ imbalance
What is the mechanism of action of mineralcorticoid receptor antagonists?
They will act as antagonist at the mineralcorticoid receptor to prevent the effects of Aldosterone. Aldosterone will create pores in the collecting allowing Na+ to be reabsorbed and K+ to be screted.
What are the two classes of drugs that are K+ sparing drugs?
mineralcorticoid receptor antagonists and Na+/K+ pore blockers
What are the two mineralcorticoid receptor antagonists?
- 1. Spironolactone
- 2. Eplerenone
What are the disadvantages of potassium sparing drugs?
- 1. Hyperkalemia
- 2. MR antagonist: slow onset, long action
- 3. MR antagonist: spironolactone is a progestin mimic
What are the two Na-K pore blockers?
- 1. Amiloride
- 2. Traimterene