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10 Cards in this Set
- Front
- Back
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Acetazolamide
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Mechanism of action:*Proximal tubule *inhibits carbonic anhydrase --> ↑HCO excretion, ↓H/Na exchange, ↓Na reabsorption
Potency:*Mild diuresis: ↓filtered Na+ by 3-5% Plasma concentration:↓Na, ↓K, ↓Ca, ↓HCO3, ↓volume Urine Concentration:↑Na, ↑K, ↑Ca, ↑HCO3, ↑volume Adverse reactions:*metabolic acidosis *Hypokalemia *kidney stones *not to be used in cirrhosis Clinical use:*glaucoma *acute mountain sickness *metabolic alkalosis *urine alkalinization (↑aspirin solubility) |
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Mannitol
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Mechanism of action:*proximal tubule and descending loop of henle *non-reabsorbable solute --> water diuresis
Potency:*Severe diuresis: ↓filtered Na+ by 20-25% Plasma Concentration:↑Na, ↑K, ↑Ca, ↑HCO3, ↓volume Urine Concentration:↓Na, ↓K, ↓Ca, ↓HCO3, ↑volume Adverse reactions:*immediate extraceullar volume expansion and hyponatremia *Later dehydration and hypernatremia if water intake is inadequate Clinical use:*rarely used *cerebral edema *surgery for head trauma |
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Furosemide
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Mechanism of action:*Ascending loop of Henle *inhibit cotransport of Na, K, 2Cl --> ↓ reabsorption of NaCl --> diuresis
Potency:*Severe diuresis: ↓filtered Na+ by 20-25% Plasma Concentration:↓Na, ↓K, ↓Ca, ↓Mg, ↑BUN ↓volume Urine Concentration:↑Na, ↑K, ↑Ca, ↑Mg, ↓BUN ↑volume Adverse reactions:*short duration of action *Hypokalemic metabolic alkalosis *ototoxicity *Hyperuricemia (RAAS PCT) *Hypomagnesemia (↓ Mg TAL) *hypovolemia *hyponatremia (H20 intake) *hypernatremia (no H20 intake) Clinical use:*acute pulmonary edema(DOC) *CHF *edema of nephritic syndrome *Hypercalcemia *Hyperkalemia |
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Chlorothiazide
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Mechanism of action:*Distal convoluted Tubule *inhibit cotransport of NaCl --> ↓reabsorption of NaCl --> diuresis
Potency:*moderate diuresis: ↓ filtered Na+ by 5-8% Plasma Concentration:↓Na, ↓K, ↑Ca, ↑BUN ↓volume Urine Concentration:↑Na, ↑K, ↓Ca, ↓BUN ↑volume Adverse reactions:*hypokalemic metabolic alkalosis *hyperuricemia *Hyponatremia *hyperglycemia *hyperlipidemia Clinical use:*ineffective when GFR is < 30 ml/min *Hypertension (mild to mod) *CHF (mild to mod) *Nephrotic syndrome w/ edema *Hypercalciuria *Nephrogenic diabetes insipidus |
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Hydrochlorothiazide
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Mechanism of action:*Distal convoluted Tubule *inhibit cotransport of NaCl --> ↓reabsorption of NaCl --> diuresis
Potency:*moderate diuresis: ↓ filtered Na+ by 5-8% Plasma Concentration:↓Na, ↓K, ↑Ca, ↑BUN ↓volume Urine Concentration:↑Na, ↑K, ↓Ca, ↓BUN ↑volume Adverse reactions:*hypokalemic metabolic alkalosis *hyperuricemia *Hyponatremia *hyperglycemia *hyperlipidemia Clinical use:*ineffective when GFR is < 30 ml/min *Hypertension (mild to mod) *CHF (mild to mod) *Nephrotic syndrome w/ edema *Hypercalciuria *Nephrogenic diabetes insipidus |
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Indapamine
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Mechanism of action:*Distal convoluted Tubule *inhibit cotransport of NaCl --> ↓reabsorption of NaCl --> diuresis
Potency:*moderate diuresis: ↓ filtered Na+ by 5-8% Plasma Concentration:↓Na, ↓K, ↑Ca, ↑BUN ↓volume Urine Concentration:↑Na, ↑K, ↓Ca, ↓BUN ↑volume Adverse reactions:*hypokalemic metabolic alkalosis *hyperuricemia *Hyponatremia *hyperglycemia *hyperlipidemia Clinical use:*effective when GFR is < 30 ml/min *Hypertension (mild to mod) *CHF (mild to mod) *Nephrotic syndrome w/ edema *Hypercalciuria *Nephrogenic diabetes insipidus |
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Metolazone
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Mechanism of action:*Distal convoluted Tubule *inhibit cotransport of NaCl --> ↓reabsorption of NaCl --> diuresis
Potency:*moderate diuresis: ↓ filtered Na+ by 5-8% Plasma Concentration:↓Na, ↓K, ↑Ca, ↑BUN ↓volume Urine Concentration:↑Na, ↑K, ↓Ca, ↓BUN ↑volume Adverse reactions:*hypokalemic metabolic alkalosis *hyperuricemia *Hyponatremia *hyperglycemia *hyperlipidemia Clinical use:*effective when GFR is < 30 ml/min *Hypertension (mild to mod) *CHF (mild to mod) *Nephrotic syndrome w/ edema *Hypercalciuria *Nephrogenic diabetes insipidus |
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Triamterene
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Mechanism of action:*collecting tubule *Inhibit epithelial Na channels *↓Na reabsorption and ↓K secretion --> diuresis
Potency:*Mild diuresis: ↓ filtered Na+ by 2-3% Plasma Concentration:↓Na, ↑K, ↓Ca, ↑BUN ↓volume Urine Concentration:↑Na, ↓K, ↑Ca, ↓BUN ↑volume Adverse reactions:*hyperkalemia *Hyperchloremic metabolic acidosis *kideney stones (triamterene) *gynecomastia (spironolactone) Clinical use:*In combination to prevent K or Mg losses *in combination for hypertension |
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Amiloride
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Mechanism of action:*collecting tubule *Inhibit epithelial Na channels *↓Na reabsorption and ↓K secretion --> diuresis
Potency:*Mild diuresis: ↓ filtered Na+ by 2-3% Plasma Concentration:↓Na, ↑K, ↓Ca, ↑BUN ↓volume Urine Concentration:↑Na, ↓K, ↑Ca, ↓BUN ↑volume Adverse reactions:*hyperkalemia *Hyperchloremic metabolic acidosis *kideney stones (triamterene) *gynecomastia (spironolactone) Clinical use:*In combination to prevent K or Mg losses *in combination for hypertension |
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Spironolactone
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Mechanism of action:*collecting tubule *Blocks aldosterone binding to receptor --> ↓protein (Na channel) synthesis, ↓Na reabsorption, ↓K secretion --> diuresis
Potency:*Mild diuresis: ↓ filtered Na+ by 2-3% Plasma Concentration:↓Na, ↑K, ↓Ca, ↑BUN ↓volume Urine Concentration:↑Na, ↓K, ↑Ca, ↓BUN ↑volume Adverse reactions:*hyperkalemia *Hyperchloremic metabolic acidosis *kideney stones (triamterene) *gynecomastia (spironolactone) Clinical use:*Primary or secondary hyperaldosteronism *in combination to prevent K or Mg losses *in combination for hypertension |
