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36 Cards in this Set

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