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38 Cards in this Set
- Front
- Back
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6 main types of Diuretics?
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CA inhibitors
Osmotic Agents Loop diuretics Thiazides K-Sparing ADH Antagonists |
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Who is the Main CA inhibitor?
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Acetazolamide
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Location of Acetazolamide's action?
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PCT
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Main Osmotic diuretic?
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Mannitol
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Where does Mannitol exert its actions?
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PCT
Thin Desc loop Collecting Duct |
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Where do loop diuretics exert their activities?
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Thick Ascending Loop
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Where do Thiazides exert their actions?
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Early DCT
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Where do K-sparing diuretics exerts their actions?
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DCT-->Collecting tubule
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Where do ADH antagonists work?
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Collecting Duct
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Clinical Uses of Mannitol?
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Shock
Drug OD Dec ICP or IOP |
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SE's of Mannitol?
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Pulm Edema
Dehydration |
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Contraindications of Mannitol?
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Anuria
CHF |
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Mech of Acetazolamide
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CA inhibitor--> self-limited NaHCO3 diuresis and reduced total-body HCO3
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Clinical uses for Acetazolamide?
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Glaucoma
Urinary Alkalinization** Metabolic Alkalosis** Altitude Sickness*** |
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SE's of Acetazolamide?
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HyperCl (to keep things neutral w/ the Na retention)
Metabolic Acidosis HypoK Sulfa allergy |
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What electrolytes does Furosemide screw up?
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Dec reabs of:
Na K Cl AND Ca |
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Clinical uses of Furosemide?
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Edematous States (CHF, Cirrhosis, nephrotic syndrome, pulm edema)
HTN HyperCa (DOC for idiopathic hyperCa) |
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SE's of Furosemide
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Sulfa Allergy
HypoK and alkalosis HypoCa HypoMg Hyperuricemia** (gout) OTOTOXIC |
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What loop can we give if our patient has a sulfa allergy? concern?
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Ethacrynic Acid
more ototoxic than furosemide |
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DDI's for Loops?
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Aminoglycosides---> Inc ototoxicity
Dec Lithium Clearance (seen w/ any loss of total body Na, e.g. vomit) Digoxin (hypoK-->inc toxicity) |
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MOA for Hydrochlorothiazide?
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Inhibits NaCl reabs in early DCT---> dec diluting capacity and dec Ca excretion
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Uses of Hydrochlorothiazide?
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HTN
CHF Idiopathic hypercalciuria (think kidney stones) Nephrogenic DI (DOC) |
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SE's of HCTZ?
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Sulfa allergy
Hypercalcemia Hyperuricemia Hyperglycemia Hyperlipidemia HypoK and Alkalosis |
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What is the only thiazide diuretic that is lipid neutral?
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Indapamide
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DDI's for Thiazides?
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Digoxin (hypoK-->inc toxicity)
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Contraindications of Thiazides?
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avoid DM pts b/c of hyperglycemia
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Who are the main K-Sparing Diuretics?
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Spironolactone
Triamterene Amiloride Eplerenone |
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MOA for Spironolactone?
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Aldo Receptor Antagonist
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Uses of Spironolactone?
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Hyperaldo states
Adjunct to K-wasting diuretics Antiandrogenic Uses (female hirsutism) CHF |
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SE's of Spironolactone?
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Antiandrogen--->man boobs and dec libido
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MOA for Amiloride and Triamterene?
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Na-Channel Blockers
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Clinical uses for Amiloride?
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Lithium-Induced Nephrogenic DI
(DOC) |
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SE's of amiloride?
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HyperK
Acidosis |
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Diuretic effects on Urine NaCl?
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INCREASED for all
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Diuretic effects on Urine K?
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Increased in all except K-sparing
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Diuretic Effects on Blodd pH
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CA-I's--> Dec pH (acidemia)
Loops and Thiazides--> inc pH (alkalemia) |
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Diuretic Effects on Urine Ca?
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Urine Ca increased w/ Loops
Urine Ca decreased w/ Thiazides |
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SE's of ACE-Inhibitors?
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Cough (not seen w/ arbs)
Angioedema Proteinuria Taste Changes HypOtension Pregnancy problems (fetal renal damage) Rash Inc Renin Lower Ang II HyperK |
