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29 Cards in this Set
- Front
- Back
What catagory is furosemide (lasiks) in?
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loop diuretics
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what is ethacrynic acid?
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loop diuretic
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when are loop diuretics used?
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combat edema associated with heart, liver and renal failure
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which increases renal blood flow to relieve pulm. congestion in heart failure?
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furosemide; left ventricular pressure are decreased (prior to diuresis)
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"other uses" of loop diuretics?
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tx mild hyperkalemia, elimination of bromide, floride, iodide ions in toxic overdoses and ACUTE renal failure
acute hypercalcemia... used with saline |
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what does fluosemide's half life depend on?
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renal function
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what are common side effects of fluosemid's and how to treat?
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hypokalemia and alkalosis; admin K+ sparking agents of KCl supplements
hypomagnesia: admin Mg supplement dehydration gouty attacks |
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Which drugs decrease diuretic effect of loop diuretics?
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NSAIDS that inhibit both COX1 & COX2
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which are the thiazide-like diuretics?
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hydrochlorothiazide, chlorthalidone, metolazone
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when are thiazide diuretics used?
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edema associated with cardiac, renal and hepatic condiations
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huge limiting factor on thiazide diuretics?
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ineffective when GFR <30 (replace with loop diuretics)
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MOST IMPORTANT application of thiazide diuretics?
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hypertension: low doses are used to manage uncomplicated hypertension
recommended as INITIAL TREATMENT |
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Thiazide use in idiopathic hypercalciuria?
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thiaz. inhibit NCC (Na/Cl symport) --> enhances activity of Na/Ca basal exchanges --> increases Na+ iinto cell and Ca++ out of cell
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which tx are thiazides used in paradoxically and unexplainably?
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diabetes insipidus
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which conditions can thiazide use unmask?
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hyperparathyroidism, sarcoidosis, paraneoplastic syndromes
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thiazides can cause hypo....
and hyper... |
natriumia (geneticall predisposed) and kalemia
and hyperuricemia, glycemia and altered lipid profile |
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thiazides and NSAIDS
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may blunt effects
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how does spironolactone bennefit those with congestive heart failure?
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antagonizes effect of aldosterone, which is thought to lead to myocardial fibrosis
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what are the untoward effects of spironolactone?
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hyperkalemia and endocrine-like (ulcers, impotence...), and breast cancer
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what are the diuretics we must know?
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spironolactone, amiloride, hydrochlorothiazide, furosemide, chlothalidone
SPIRITED ANIMALS make HIGH quality FUR CLOTHING |
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what happens in the proximal tubule?
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virutally all organic metabolites resorbed, water is passively resorbed, ==
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which are the loop diuretics?
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furosemide, ethacrynic
LOOPY EARTH hippies CRY over FUR jackets |
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why are ACE inhibitors commonly administered with loop diurectics?
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because loop diuretics ultimately decrease Na/Cl, and macula densa senses this and stimulates the JG cells to secrete renin. ACEI inhibits angiotensin converter enzyme (ATI --> ATII)
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which diuretics act on the DCT Na+/Cl- symporter?
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hydrochlorothiazide, metolazon, chlorthalidone (thiazide diuretics)
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why do loop and thiazide diuretics result in a loss of K+?
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becuase they increase Na+ load at the principal cell in the late distal tubule/collecting duct. This increases K+ loss from principal cells..
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which drug inhibits specifically ENaC?
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amiloride
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what is the principal use of amiloridE?
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blunt hypokalemic SEs produced by diuretics
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what are the potassium sparing diuretics?
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amiloride and spironolactone.... (spir competes with aldosterone while amil blocks ENaC)
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which drug blocks aldosterone and can antagonize myocardial fibrosis?
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spironolactone
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