Diuretics

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Author:
xinchen3
ID:
196221
Filename:
Diuretics
Updated:
2013-01-28 22:22:06
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Diuretics
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Diuretics
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  1. Thiazide - MoA
    • inhibit Na/Cl channel in distal tubule
    • leads to increase distal delivery of Na+
  2. Thiazide - special action
    • promotes Ca2+ reabsorption
    • good for osteoporosis & Ca2+ kidney stones
  3. Thiazide - Use
    • first line therapy => mild diuretics
    • severe edema
    • osteoporosis
    • Manage Ca2+ kidney stones
    • Nephrogenic Diabetes Insipidus
  4. What is Nephrogenic Diabetes Insipidus
    • when kidney does not respond to ADH
    • Thiazide can cause decrease volume leading to increase proximal water reabsorption (in theory)
  5. Thiazide - Adverse Effects
    • Electrolyte imbalance (inc. Ca; dec. Na & K)
    • Hyperuricemia (dec. excretion of uric acid; Gout)
    • Hyperglycemia, Hyperlipidemia (all about concentration)
    • Impotence
  6. Thiazide - Contraindications
    • Sulfonamide toxicity (antibiotic)
    • K-depletion drugs (Digoxin & Quinidine)
    • NSAIDs
  7. Loop Diuretics - MoA
    • inhibits NKCC channels in ascending loop
    • increase distal delivery of Na
  8. Loop Diuretics - Use
    • acute pulmonary edema
    • CHF
    • Nephrotic syndrome, cirrhosis
    • acute renal failure
    • HTN
    • hyperkalemia, hypercalcemia
  9. Loop Diuretics - Adverse Effects
    • Electrolyte imbalance (dec. Na, K, Ca, Mg)
    • Hyperuricemia (exacerbates Gout)
    • Metabolic Alkalosis
    • Hyperglycemia & Hyperlipidemia
    • Ototoxicity
  10. Loop Diuretics - contraindications
    • K-depletion drugs (digoxin & quinidine)
    • Ototoxicity causing drugs (Aminoglycoside)
    • NSAIDs
  11. What happens when you increase distal delivery of Na?
    • increase K excretion => hypokalemia
    • increase H+ excretion => alkalosis
  12. What is the difference between Thiazide & Loop Diuretics effect on Calcium?
    • Thiazide - increase Ca2+ reabsorption
    • Loop Diuretic - decrease Ca2+ reabsorption
  13. How are Loop Diuretic different from Thiazide in potency?
    • Loop Diuretics are stronger diuretics
    • shorter duration & looses effectiveness over time
    • good for emergency short term, fast action use!
    • for long term therapy, use Thiazide
  14. Spironolactone
    Aldosterone antagonist
  15. Eplerenone
    Aldosterone antagonist
  16. Aldosterone antagonist - MoA
    • block aldosterone effect on Na channels in distal tubules
    • K sparing diuretic
  17. Aldosterone antagonist - Use
    use in conjunction with other diuretics for K sparing action
  18. Aldosterone antagonist - Adverse Effects
    • Hyperkalemia
    • Renal insufficiency (controls blood vessels)
    • Metabolic acidosis (inc K => K/H exchange)
    • Gynecomastia, Impotence, Hirsutism
  19. Amiloride
    Na channel blocker
  20. Triamterene
    Na Channel blocker
  21. Na channel blockers - MoA
    • blocks Na channels in distal tubule
    • K-sparing diuretics
  22. Na channel blockers - Use
    weak diuretic used in combination with other diuretics for K sparing effect
  23. Na channel blocker - Adverse Effects
    • Hyperkalemia
    • Renal insufficiency
    • Metabolic acidosis
    • Kidney stones (basic urine)
  24. Carbonic Anhydrase Inhibitor
    • inhibits Carbonic Anhydrase in proximal tubule
    • increase distal delivery of Na

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