Diuretics

Front 1

mannitol classification and mechanisms?

Back 1

osmotic diuretic
-increase osmolality of tubular fluid
-cause movement of water out of cells resulting in increased renal blood flow

Front 2

mannitol therapeutic use?

Back 2

decrease intracranial pressure in patients with certain neurological problems;
not widely used as diuretics

Front 3

acetazolamide?

Back 3

carbonic anhydrase inhibitor;
decrease NaHCO3 reabsorption

Front 4

adverse effects of acetazolamide?

Back 4

metabolic acidosis (CA inhibitor)

Front 5

acetazolamide therapeutic use?

Back 5

glaucoma;
infrequently used as diuretics

Front 6

loop diuretics mechanism of action?

Back 6

inhibit Na+K+2Cl- symporter in thick ascending limb of the loop of henle

Front 7

effects of loop diuretics?

Back 7

block salt reabsorption;
decrease preload;
increase urinary calcium excretion

Front 8

importance of organic acid secretory system?

Back 8

many diuretics utilize it to get to their site of action in the lumen

Front 9

adverse effects of loop diuretics?

Back 9

hypokalemia, metabolic alkalosis
hyperuricemia
hyperglycemia
alteration in lipids
volume depletion
hyponatremia
hypomagnesemia
ototoxicity
allergic reactions

Front 10

consequences of hypokalemia?

Back 10

risk of cardiac arrhythmias
potentiates effects of digitalis on heart and increases risk of digitalis toxicity

Front 11

loop diuretics?

Back 11

furosemide
bumetanide
ethacrynic acid
torsemide

Front 12

which of loop diuretics is less commonly associated with allergic reactions?

Back 12

ethacrynic acid

Front 13

ototoxicity is most often associated with which loop diuretic?

Back 13

ethacrynic acid

Front 14

thiazides?

Back 14

hydrochlorothiazide
chlorthalidone
metolazone
chlorothiazide

Front 15

thiazide mechanism of action?

Back 15

inhibit NaCl symptorter in luminal membrane of distal convoluted tubule to block salt reabsorption

Front 16

thiazide effects?

Back 16

block salt reabsorption;
decrease peripheral vascular resistance;
increase calcium reabsorption

Front 17

treatment of hypercalcemia?

Back 17

furosemide plus saline

Front 18

treatment of kidney stones due to idiopathic hypercalciuria?

Back 18

thiazides

Front 19

adverse effects of thiazides?

Back 19

hypokalemia, metabolic alkalosis
hyperuricemia
hyperglycemia
increase in serum lipids
volume depletion
hyponatremia
allergic reactions

Front 20

hydrochlorothiazide?

Back 20

thiazide diuretic

Front 21

chlorthalidone?

Back 21

thiazide diuretic

Front 22

metolazone?

Back 22

thiazide diuretic

Front 23

chlorothiazide?

Back 23

thiazide diuretic
available in IV preparation

Front 24

furosemide?

Back 24

loop diuretic

Front 25

bumetanide?

Back 25

loop diuretic

Front 26

ethacrynic acid?

Back 26

loop diuretic

Front 27

torsemide?

Back 27

loop diuretic

Front 28

triamterene?

Back 28

k-sparing diuretic: sodium channel blocker

Front 29

amiloride?

Back 29

k-sparing diuretic: sodium channel blocker

Front 30

subtypes of k-sparing diuretics?

Back 30

sodium channel blockers
mineralcorticoid receptor antagonists

Front 31

mechanism of k-sparing sodium channel blockers?

Back 31

inhibit Na channels in luminal membrane in late distal tubule and collecting duct to decrease Na reabsorption and K and H excretion

Front 32

therapeutic use of k-sparing sodium channel blockers?

Back 32

combination with thiazide or loop diuretics: increase effects and blunt k wasting of other diuretics

Front 33

adverse effects of k-sparing sodium channel blockers?

Back 33

hyperkalemia

Front 34

when is risk for hyperkalemia higher?

Back 34

renal disease
potassium supplements
ACE inhibitors
angiotensin II blockers
beta blockers
NSAIDS

Front 35

spironolactone?

Back 35

k-sparing mineralocorticoid receptor antagonist

Front 36

eplerenone?

Back 36

k-sparing mineralocorticoid receptor specific antagonist

Front 37

mechanism of spironolactone?

Back 37

competitive antagonist of aldosterone;
binds cytoplasmic receptor preventing binding of aldosterone;
decrease Na reabsorption in late distal tubule and collecting duct;
decreases K and H excretion

Front 38

therapeutic uses of spironolactone?

Back 38

disease states with elevated aldosterone levels;
combination with thiazide or loop diuretics

Front 39

causes of secondary hyperaldosteronism?

Back 39

heart failure
cirrhosis with ascites

Front 40

adverse effects of spironolactone?

Back 40

hyperkalemia
endocrine effects

Front 41

clinical uses of diuretics?

Back 41

edematous (heart failure, cirrhosis with ascites, nephrotic syndrome)
nonedematous (hypertension, hypercalcemia, kidney stones due to idiopathic hypercalciuria, nephrogenic diabetes insipidus)

Front 42

what is unique about spironolactone site of action compared with that of other diuretics?

Back 42

intracellular - others are secreted into lumen where have effect on luminal membrane

Front 43

drugs affecting renal water reabsorption?

Back 43

vasopressin
desmopressin
demeclocycline
lithium
conivaptan
tolvaptan

Front 44

desmopressin versus vasopressin?

Back 44

increased antidiuretic-to-pressor activity

Front 45

actions of ADH?

Back 45

increase permeability of renal collecting duct cells to water (V2);
vasoconstriction (V1)

Front 46

V1 receptor?

Back 46

mediates vasoconstriction

Front 47

V2 receptor?

Back 47

mediates insertion of water channels into luminal membrane

Front 48

therapeutic uses of vasopressin and desmopressin?

Back 48

central diabetes insipidus

Front 49

adverse effects of ADH?

Back 49

water intoxication (V2);
vascular and GI effects (V1);
allergic reactions

Front 50

demeclocycline?

Back 50

ADH antagonist

Front 51

lithium?

Back 51

ADH antagonist

Front 52

demeclocycline, lithium mechanism and adverse effects?

Back 52

decrease ADH effect on renal collecting duct cells;
nephrogenic diabetes insipidus

Front 53

conivaptan?

Back 53

ADH antagonist;
V1A and V2 antagonist resulting in increased free water excretion

Front 54

conivaptan use?

Back 54

short term treatment for euvolemic hyponatremia

Front 55

how is conivaptan administered?

Back 55

IV

Front 56

adverse effects of conivaptan?

Back 56

infusion site reactions;
too rapid correction of low serum Na concentrations

Front 57

what condition is conivaptan not approved to treat?

Back 57

heart failure

Front 58

tolvaptan?

Back 58

new ADH antagonist

Front 59

contraindications for ADH antagonists?

Back 59

hypovolemic hyponatremia
potent CYP3A4 inhibitors