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29 Cards in this Set

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