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36 Cards in this Set
- Front
- Back
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Name four osmotic diuretics.
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mannitol, isosorbide, glycerin, urea
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How do osmotic diuretics work? What part of the kidney tubule is this?
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They are freely filtered through the PCT, taking water with them as they go.
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Which two osmotic diuretics may be given IV?
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mannitol and urea
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What are the uses of mannitol?
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prevention and treatment of acute renal failure, tx closed angle glaucoma
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What is the only use of both isosorbide and glycerin?
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ophthalmology
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Which osmotic diuretic is metabolized? To what? What side effects may this cause?
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glycerin to glucose; hyperglycemia or glycosuria
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What is the side effect of mannitol?
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pseudohyponatremia
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What is the side effect of urea?
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thrombosis
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Who should not take an osmotic diuretic? Why?
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A patient with CHF b/c it may cause decompensation
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Name two carbonic anhydrase inhibitors.
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Acetazolamide and dorzolamide
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How do carbonic anhydrase inhibitors work? What part of the tubule is this?
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Inhibiting CA decreases the H+ in the serum, which decreases the transport of H+ in exchange for Na+, effectively interfering with Na+ reabsorption; PCT
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What are the uses of acetazolamide? 4
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glaucoma, metabolic alkalosis from thiazide diuretics, acute mountain sickness, and as an adjuvant in the treatment of epilepsy
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What are the side effects of acetazolamide? 4
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metabolic acidosis (no bicarbonate), CNS effects (paresthesias, drowsiness, transient myopia), hypokalemia, and renal stones
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Name the two thiazide-like diuretics.
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indapamide and metolazone
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How do thiazides work? What part of the tubule is this?
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They inhibit a Na+/Cl- cotransporter in the early distal tubule
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What are the uses of thiazides?
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mild hypertension, diuresis of edema (especially in CHF), nephrolithiasis (increase calcium reabsorption), osteoporosis, and nephrogenic diabetes insipidus (decrease ECFV and GFR)
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What are the side effects of thiazides?
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hypercalcemia, hypokalemia, hyperuricemia, hyperglycemia (in diabetics), and hyperlipidemia (except indapamide)
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Who should not take thiazides?
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patients with CHF and pulmonary edema, patients taking digitalis, patients with diabetes
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Name four loop diuretics.
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furosemide, torsemide, ethacrynic acid, bumetanide
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How do loop diuretics work? Which part of the tubule is this?
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They inhibit a Na+/2Cl-/K+ transporter in the ascending loop of Henle.
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Why are loop diuretics more effective than other diuretics?
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They work at the ascending loop of Henle, where the most NaCl reabsorption takes place.
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How are loop diuretics administered?
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orally or parenterally
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What are the uses of loop diuretics?
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edematous states (including acute pulmonary edema), hypertension (not mild), and hypercalcemia
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What are the side effects of loop diuretics?
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hypotension, hypokalemia, metabolic alkalosis, hyperuricemia, ototoxicity (esp. ethacrynic acid), allergic interstitial nephritis, hyperglycemia, and GI disturbances (esp. ethacrynic acid)
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Which three drugs do loops interact with and what is the result of the interaction?
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oral hypoglycemics, lithium (decrease lithium clearance), and aminoglycosides (increase ototoxicity and nephrotoxicity)
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Name three potassium-sparing diuretics.
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spironolactone, amiloride, triamterene
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How do potassium-sparing diuretics work? What part of the tubule is this?
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All of these diuretics act on the collecting tubule and inhibit the reabsorption of Na+ which inhibits the secretion of K+
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What makes spironolactone different?
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It is an aldosterone receptor antagonist
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How is spironolactone absorbed and metabolized?
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orally, by the liver
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What is the general use of a potassium-sparing diuretic?
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with potassium-losing diuretics (esp. thiazides) to treat edematous states (esp. in the presence of high aldosterone levels)
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What other uses does spironolactone have?
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It treats/diagnoses primary hyperaldosteronism and treats polycystic ovary disease and female hirsutism. It is the drug of choice in the treatment of edema and ascites associated with hepatic cirrhosis.
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What other uses does amiloride have?
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It treats lithium-induced nephrogenic diabetes insipidus and cystic fibrosis
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Which side effects are common to all potassium-sparing diuretics?
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Hyperkalemia and nausea
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What other side effect does spironolactone have?
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gynecomastia
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What other side effects does triamterene have?
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It causes leg cramps and megaloblastic anemia in patients with alcoholic cirrhosis
(inhibition of DHF reductase). |
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Name an ADH antagonist. What does it treat?
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Demeclocycline. SIADH.
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