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6 Cards in this Set
- Front
- Back
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Osmotic diuretics
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Mannitol
- limits water reabsorption in segments permeable to water - works on thin descending limb of loop of Henle and proximal tubule - water diuresis > salt diuresis USES - control intraocular pressure for glaucoma and reduces cerebral edema CI - Renal or Cardiac failure Precautions: electorlyte imbalance, hypovolemia, geriatric ots, pregnant lactation |
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Carbonic Anhydrase Inhibitors
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Acetazolamide
- works on proximal tubule, and collecting duct - almost completely stops NaHCO3 reabsorption due to inhibition of cystolic CA - solutes delivered to macula densa, causing reduction of renal blood flow and GFR USE - open angle glaucoma, prevents production of HCO3-, delivered in eye drops - also PREVENTS altitude sickness CI - acidemia (metabolic acidosis), anuria, closed angle glaucoma, hypokalemia, hponatremia, renal failure (NOTE- all diuretics are CI w renal failure) Precautions: acid-base imbalance, hypersensitivity, dialysis, driving or operating machinery, electrolyte imbalance, breast feeding, pregnancy, respiratory acidosis SE: agranulocytosis, anaphylatic shock, hyperuricemia, hypokalemia, metabolic acidosis |
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Loop diuretics
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Furosemide
- works on thick ascending limb - essentially stops salt transport, and as a result reabsorption of Ca2+ and Mg+ decreases - MOST EFFICACIOUS DIURETIC - PROBLEM - ototoxicity, hyperuricemia, hypotension, hypokalemia, hypomagnesemia - uses - edemas, congestive heart failure, hypertension - CI - anuria, post MI cardiogenic shock (aggravates shock) - Precautions - hyperglycemia, hyperuricemia (uric acid secretion inhibited by diuretics), breast feeding, electrolyte imbalance |
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Thiazide diuretics
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Hydrochlorothiazide
- works on distal convoluted tubule - inhibition of Na+Cl- symporters - chronic use - decreases Ca2+ excretion, enhancing Na+/Ca2+ exchange at basolateral membrane - uses - hypertension, edema, hypocalcemia, nephrolithiasis, and diabetes insipidus - SE - hypokalemia, hypochloremia, hypercalcemia, impaired glucose tolerace and sexual dysfunction - CI - anuria, sulfonamide hypersensitivity, thiazide diuretic hypersensitivity |
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Potassium-sparing diuretics
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Triamterene (Spironolactone)
- works on late distal tubule and collecting duct - blocks Na+ uptake, driving K+ into the lumen - relieves hyperkalemia - SE - hypokalemia - Precautions - gout, pregnancy, acid-base imbalance |
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ADH antagonist
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Conivaptan
- antagonists at V2 receptors - causes water diuresis, can relieve hyponatremia - used for SIADH and chronic euvolemic hyponatremia |
