Loop Diuretics

Front 1

If given concurrently with aminoglycosides, what diuretics result in ototoxicity? What is a better alternative?

Back 1

Loop diuretics + aminoglycosides result in ototoxicity

Use Thiazides instead

Front 2

How do loop diuretics affect Ca reabsorption?

Back 2

Proximal tubule and the Henle's loop have parallel mechanisms when it comes to filtration/reabsorption of Na and Ca. Loop diuretics decrease reabsorption of Ca and Na.
Thus, loop diuretics can be used as a TX for hypercalcemia.

Front 3

List Loop Diuretics and their MOA

Back 3

Furosemide
Torsemide
Bumetanide
Ethacrynic Acid

Thick Ascending Segment of the Loop of Henle
Na-2Cl-K transporter blockade

Front 4

Which loop diuretic is approved for TX of edema and hypertension?

Back 4

Torsemide

Front 5

How do loop diuretics increase renal blood flow?

Back 5

They increase production of PGI2, which is a vasodilator. (which is antagonized by the use of NSAIDS, thus their renal toxicity, with chronic use leading to renal ischemia)

Front 6

What other drugs if given concurrently with loop diuretics result in MILD toxicities (Mild if compared to thiazides)?

Back 6

Quinidine
Digoxin
Lithium

(toxicity for quinidine and digoxin is bar far higher if given with thiazides)

Front 7

Describe Loop diuretics' adverse effects and toxicity

Back 7

Decreased plasma Na, K, Mg, Ca
Volume depletion, hypotension, collapse (possible)
Arrhythmia
Hyperuricemia, at times leading to gout
Adverse lipid profile: LDL, TG
Skin Rashes

Front 8

How do NSAIDs interact with Loop diuretics?

Back 8

One of the MOAs of loop diuretics is their increase of synthesis of PGI2, renal vasodilator. Adding NSAID, results in PGI2 decrease and renal vasoconstriction, which reduces renal blood flow.