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16 Cards in this Set

  • Front
  • Back
mxn: osmotic diuretic, + urine osmolarity to + urine flow

C: shock, drug OD, - intracranial/intraocular pressure

tox: pulm edema, dehydration, CHF, don't use in anuria
mxn: carbonic anhydrase inhibitor, cause self-limited NaHCO3 diuresis, reduce body bicarb stores, act at proximal convoluted tubule

C: glaucoma, urinary alkalization, metabolic alkalosis, altitude sickness

tox: hyperchloremic metabolic acidosis, neuropathy, NH3 tox, sulfa allergy
mxn: sulfonamide loop diuretic, blocks cotransport of Na/K/2Cl of thick AL, abolish hypertonicity of medulla and prevents concentration of urine, increase Ca++ excretion

C: edema states (CHF, cirrhosis, nephrotic syndrome, pulm edema), hypertension, hypercalcemia

tox: OH DANG! (Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis (interstitial), Gout
Ethacrynic acid
mxn: phenoxyacetic acid derivative (NOT a sulfa), same action as furosemide

C: diuresis for pts allergic to sulfa

tox: similar to furosemide, can be used in hyperuricemia, acute gout (not used to treat gout)
mxn: thiazide diuretic, blocks NaCl reabsorption in early distal tubule, reduces diluting capacity of nephron, decrease Ca++ secretion

C: hypertension, CHF, idiopathic hypercalciuria, nephrogenic diabetes insipidus

Tox: hypokalemic metabolic alkalosis, hyponatremia, hyperGLUC (-Glycemia, -Lipidemia, Uricemia, -Calcemia), sulfa allergy
What are the 3 big K+ sparing diuretics?
"The K+ STAys"
- Spironolactone
- Triamterene
- Amiloride
What are the mxn, clinical use, and tox of K+ sparing diuretics?
mxn: Spironolactone is a competitive aldosterone receptor antagonist in the cortical collecting tubule. Triamterene and amiloride act in the same area by blocking the Na+ channels.

C: hyperaldosteronism, K+ depletion, CHF

tox: hyperkalemia, endocrine effects (eg. spironolactone causes gynecomastia, antiandrogen effects)
What diuretics increase urine NaCl?
all: carbonic anhydrase inhibitors, loop diuretics, thiazides, K+ sparing diuretics
Which diuretics increase urine K+?
All except the K+ sparing diuretics.
Which diuretics lead to a decrease in blood pH (acidosis)?
CA inhibitors, K+ sparing diuretics
Which diuretics cause an increase in blood pH (alkalosis)?
loop diuretics and thiazide diuretics
How do diuretics affect urine Ca++?
loop diuretics increase urine calcium, while thiazides decrease urine calcium
Nifedipine, verapamil, diltiazem
Mxn: calcium channel blockers; act on L-type voltage-dependent channels of smooth muscle and cardiac muscle; verapamil is most sensitive on heart tissue, followed by diltiazem

Clin: HTN, angina, arrhythmias (not nifedipine)

Tox: cardiac depression, peripheral edema, flushing, dizziness, constipation
captopril, enalapril, lisinopril
mxn: ACE inhibitor; lowers angiotensin II levels and prevents inactivation of bradykinin (vasodilator)

clin: HTN, CHF, diabetic renal disease

tox: CAPTOPRIL (Cough, Angioedema, Proteinuria, Taste changes, hypOtension, Pregancy problems, Rash, Increased renin, Lower angiotensin II) and hyperkalemia
angiotensin II receptor blocker (ARB); does NOT cause cough
nitroglycerine, isosorbide dinitrate
mxn: vasodilate by releasing NO in smooth muscle, cause + in cGMP and smooth muscle relaxation; dilates veins >> arteries

clin: angina, pulm edema, aphrodisiac, erection enhancer

tox: tachycardia, hypotension, headache, "Monday disease"