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What is the mechanism of action of Thiazides?
Where is the site of action?
Thiazides are ___ _______.
- inhibit Na and Cl reabsorbtion
- ascending loop of henle
- K wasting
-
Name 4 thiazides:
- Chlorothiazide
- hydrochlorothiazide
- benzthiazide
- cyclothiazide
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Clinical uses of Thiazides:
- essential HTN
- Edema
- Diabetes insipidus
- hypercalcemia
-
What are the short and long term affects of Thiazides?
- short term: decrease extracellular volume and CO
- long term: peripheral vasodilation.
-
What is the major side effect of Thiazides?
- HypoK HypoCl metabolic acidosis
- dysrhthmias
- HYPERURICEMIA (gout aggravation)
- renal and hepatic failure?
-
Name two LOOP Diuretics:
- Ethacrynic Acid
- Furosemide
-
Loop diuretics _______ ___ reabsorption in the medullary portion of ascending ____ __ _____.
-
Loop diuretics are NOT USED to treat _________ ___.
Essential HTN
-
What are 3 clinical uses for Loop diuretics?
- Edema mobilization
- ICP tx (but mannitol preferred)
- Diff dx of oliguria
-
What are side fx of LOOP Diuretics?
- fluid/ ion imbalance
- hypokalemia
- increase digitalis tox
- potentiate NMB's
- Hyperuricemia
- Aminoglycoside tox (by inc plasma conc)
- sulfonamide allergy (sulfur in molecule!)
-
Pt's with a sulfonamide allergy may be allergic to what diuretic?
Loop
-
Name 2 Osmotic Diuretics:
-
Osmotic Diuretics are freely filterable at the __________, undergo _______ reabsorption, ______ __________, and are pharmacology _____.
- glomerulus
- limited
- resist metabolism
- inert
-
What is the mechanism of action of Osmotic Diuretics?
- increases osmolarity of renal tubular fluid, prevents reabsoption of water.
- increase plasma osmolarity
-
Name clinical uses for Osmotic Diuretics include prophylaxis against _____ _______, diff dx of ________, tx of increased ___, and reduction of _____________ pressure.
- renal failure
- oliguria
- ICP
- intraocular
-
Two K+ sparing diuretics include, T__________, and A________.
-
What area of the kidneys do K+ sparing diuretics affect? Why are the used? What is a side effect?
- convoluted tubules
- used with other diuretics or in place of a diuretic if low K+ is a concern
- HYPERKALEMIA
-
What are the side effects of Osmotic Diuretics?
- Pulmonary Edema
- Hypovolemia
- Electrolyte imbalance
- plasma hyperosmolarity
-
Name one Aldosterone Antagonist: What is a clinical use?
- Spirinolactone
- tx of ascites
-
Carbonic anhydrase inhibitors include the drug A____________, which fx the __________ ducts and inhibit ______ reabsoption. They are used clinically for ___ surgery.
- Acetazolamide
- collecting
- NaHCO3
- EYE
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