Diuretics

Front 1

Name the carbonic anyhydrase inhibitors

Back 1

Acetazolamide and Dorzolamide

Front 2

Name the thiazides and congeners

Back 2

Hydrochlorothiazide and Indapamide

Front 3

Name the loop diuretics

Back 3

Furosemide and Ethacrynic acid

Front 4

Name the K sparing diuretics

Back 4

Triamterene, amiloride, and spirinolactone

Front 5

Name the osmotic diuretics

Back 5

Mannitol

Front 6

Name the ADH antagonists

Back 6

Conivaptan

Front 7

S.O.A/M.O.A of carbonic anhydrase inhibitors

Back 7

Proximal Tubule, inhibits NaHCO3 reabsorption

Front 8

S.O.A/M.O.A of loop diuretics

Back 8

TAL of Henle Loop, block the Na/K/Cl symport

Front 9

SOA/MOA of thiazides

Back 9

EDT, block the Na/Cl symport

Front 10

SOA/MOA of K sparing diuretics

Back 10

LDT, CCT, blocks Na channels and blocks aldosterone receptors

Front 11

SOA/MOA of osmotic diuretics

Back 11

TDL of Henle Loop and prox tubule, increases osmolarity of tubular fluid

Front 12

Carbonic Anhydrase Inhibitors MOA

Back 12

inhibits membrane bound CA in cells of prox tubule

Front 13

Renal effects of Carbonic anhydrase inhibitors

Back 13

metabolic acidosis because hyperchloremia

Front 14

Other effects of carbonic anhydrase

Back 14

block CA in ciliary body(decreases production of aqueous humor)
-block CA in choroid plexus, decreases prodn of csf

Front 15

A/Es of carbonic anhydrase inhibitors

Back 15

paresthesias, **SULFA type allergic rxns

Front 16

therapeutic uses of carbonic anhydrase inhibitors

Back 16

open angle glaucoma, acute mountain sickness, edema from heart failure, epilepsy

Front 17

what are all thiazide and congeners

Back 17

sulfonamides

Front 18

what are thiazides MOA

Back 18

inhibit Na/Cl cotransporter on luminal surface of early DCT

Front 19

with the exception of indapamide and metolazone, what value of GFR does the diuretic effect of thiazides disappear?

Back 19

less than 30 ml/min

Front 20

what affect do thiazides have on vasculature?

Back 20

arteriolar vasodilation

Front 21

A/Es of thiazides

Back 21

hypokalemia, hyperuricemia, sexual dysfunction,

Front 22

therapeutic uses of thiazides

Back 22

HTN(first choice diuretics), edema associated with heart, liver, kidney, ascites,

Front 23

which of the loop diuretics are sulfonamides

Back 23

furosemide, bumetanide, torsemide

Front 24

MOA of loops diuretics

Back 24

inhibits Na/K/Cl of TAL leads to decreased lumen positive potentially, decreased hypertonicity of medulla therefore decreased ability of kidney to concentrate the urine, and inhibition of mac densa sensitivity

Front 25

does the diuretic effect of loop diuretics remain when GRR less than 30 ml/min?

Back 25

yes

Front 26

what are the vascular effects of loop diuretics

Back 26

vasodilation in venous bed

Front 27

A/E of loop diuretics

Back 27

tinnitus, hearing loss, SULFA rxn

Front 28

therapeutic uses of loop diuretics

Back 28

acute pulmonary edema, heart failure, edema assoc with chronic renal failure or nephrotic syndrome, ascites, HTN

Front 29

what can be used with loops to increase effectiveness when loop alone not working

Back 29

thiazide

Front 30

which of the K sparing diuretics is a steroid?

Back 30

spironolactone

Front 31

what is the MOA of spironolactone?

Back 31

blocks aldosterone receptors in late distal tubule and cortical collecting tubules

Front 32

what is the MOA of triamterene and amiloride?

Back 32

directly block Na channels in luminal membrane of late distal tubule and cortical collecting tubule

Front 33

A/E of all K sparing

Back 33

hyperkalemia

Front 34

A/E of spironolactone

Back 34

sexual dysfunction

Front 35

A/E of loop diuretics

Back 35

tinnitus, hearing loss, SULFA rxn

Front 36

C/I of all K sparing diuretics

Back 36

beta blockers and ACEI

Front 37

therapeutic uses of loop diuretics

Back 37

acute pulmonary edema, heart failure, edema assoc with chronic renal failure or nephrotic syndrome, ascites, HTN

Front 38

therapeutic uses of spironolactone

Back 38

primary hyperaldosteronism(adrenal adenoma, adrenal hyperplasia), secondary hyperaldosteronism(hepatic cirrhosis, CHF), heart failure

Front 39

what can be used with loops to increase effectiveness when loop alone not working

Back 39

thiazide

Front 40

which of the K sparing diuretics is a steroid?

Back 40

spironolactone

Front 41

what is the MOA of spironolactone?

Back 41

blocks aldosterone receptors in late distal tubule and cortical collecting tubules

Front 42

what is the MOA of triamterene and amiloride?

Back 42

directly block Na channels in luminal membrane of late distal tubule and cortical collecting tubule

Front 43

A/E of all K sparing

Back 43

hyperkalemia

Front 44

A/E of spironolactone

Back 44

sexual dysfunction

Front 45

C/I of all K sparing diuretics

Back 45

beta blockers and ACEI

Front 46

therapeutic uses of spironolactone

Back 46

primary hyperaldosteronism(adrenal adenoma, adrenal hyperplasia), secondary hyperaldosteronism(hepatic cirrhosis, CHF), heart failure

Front 47

Therapeutic uses of amiloride

Back 47

lithium induced nephrogenic diabetes insipidus

Front 48

therapeutic uses of K sparing

Back 48

treatment and prevention of hypokalemic states with therapy with loop diuretics and thiazides

Front 49

MOA of osmotic diuretics

Back 49

limit water reabsorption in thin descending limb and prox tubule

Front 50

A/E of osmotic diuretics

Back 50

extracellular volume contraction with high doses when kidney normal(hypovolemia, dehydration), extracellular volume expansion in pts with cardiac or renal disease which can cause hypervolemia

Front 51

C/I of osmotic diuretics

Back 51

severe renal failure, heart failure, pulm edema, severe dehydration

Front 52

therapeutic uses of osmotic diuretics

Back 52

reduce cerebral edema pre/post surgery, reduce intraocular pressure in acute angle closure glaucoma, reduce intraocular pressure before and after iridotomy

Front 53

MOA of ADH antagonists

Back 53

antagonists at vasopressin receptors, conivaptan at v1a and v2, and tolvaptan at v2

Front 54

what is conivaptan a strong inhibitor of

Back 54

cyp34a

Front 55

therapeutic uses of ADH antagonists

Back 55

SIADH

Front 56

what is the value for hypokalemia

Back 56

less than 3.5mEq/L

Front 57

what are some causes of hypokalemia

Back 57

excess renal loss, GI losses, ecf to icf shifts, insufficient intake, drugs

Front 58

S/S of hypokalemia

Back 58

skeletal muscle weakness, flaccid muscle paralysis, resp failure, disturbances in cardiac repol

Front 59

treatment of hypokalemia

Back 59

potassium chloride orally or IV

Front 60

what is the value of hyperkalemia

Back 60

greater than 5.3mEq/L

Front 61

causes of hyperkalemia

Back 61

diminished renal excretion, transcellular shift, increase in intake, drugs

Front 62

s/s of hyperkalemia

Back 62

disturbances in cardiac excitability and conduction, flaccid paralysis

Front 63

treatment of hyperkalemia

Back 63

insulin and glucose, calcium gluconate