Renal pharm

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Renal pharm
2011-03-15 16:22:29
Renal pharm

Renal pharm
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  1. Mannitol
    • Osmotic diuretic (PCT and collecting duct)
    • Used in shock, drug OD, to decrease intracranial/intraocular pressure
    • Tox - pulmonary edema, dehydration; don't use in anuria
  2. Acetazolamide
    • Carbonic anhydrase inhibitor (proximal tubule)
    • Used in glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness
    • Tox - metabolic acidosis, neuropathy, NH3 tox, sulfa allergy
  3. Furosemide
    • Loop diuretic, inhibits NKCC
    • Increased Ca excretion
    • Used in edematous states, hypertension, hypercalcemia
    • Make urine isothenuric (abolish hypertonicity)
    • Can be used in GFR <40
    • Tox - OH DANG - Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis (interstitial), Gout, contraction alkalosis
  4. Ethacrynic acid
    Like furosemide but not sulfa
  5. HCTZ
    • Thiazide diuretic, inhibits NCCT in distal convoluted tubule
    • Decreases Ca excretion
    • Used in HTN, CHF, idiopathic hypercalciuria (renal calcium stones), nephrogenic DI
    • Can't be used if GFR <40
    • Hypokalemic matabolic alkalosis, hyponatremia, sulfa allergy + hyperGLUC (glycemia, lipidemia, uricemia, calcemia), contraction alkalosis
  6. Spironolactone
    • K-sparing diuretic
    • Competitive aldosterone receptor antagonist in CCT
    • Used in hyperaldosteronism, hypoK, CHF
    • Can't be used if GFR <40
    • Hyperkalemia -> arrythmia, gynecomastia
  7. Amiloride, triamterene
    • K-sparing diuretic
    • Block Na channels in CCT
    • Used in hyperaldosteronism, hypoK, CHF
    • HyperK -> arrythmia
  8. Captopril
    • ACEI
    • Increases renin release
    • Used in HTN, CHF, diabetic renal dz
    • Cough, angioedema, fetal renal damage
    • Don't give in bilateral renal artery stenosis
    • -sartans are ARBs - no cough