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8 Cards in this Set
- Front
- Back
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Mannitol
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Mechanism- Works in the PCT. Osmotic diuretic, increases tubular fluid osmolarity to increase urine flow.
Use- Shock, drug overdose, increased intracranial/intraocular pressure (glaucoma) Toxicity- Pulmonary edema, dehydration. CX in anuria, CHF. Hyponatremia (losing free water) |
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Acetazolamide
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Mechanism- Works in the PCT. Carbonic anhydrase inhibitor that causes self-limited NaHCO3 diuresis and reduction in total body HCO3 stores.
Use- Glaucoma (slow), urinary alkalinization, metabolic alkalosis, altitude sickness (get respiratory alkalosis because of increased ventilation and decreased CO2) Toxicity- Hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy |
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Furosemide, Bumetinide, Torsemide
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Mechanism- Works at the TAL. Sulfonamide loop diuretic. Inhibits cotransport system (Na,K,2Cl) of TAL of loop Henle. Abolishes hypertonicity of medulla to prevent the concentration of urine, increases Ca excretion.
Clinical use- Edematous states (CHF, cirrhosis, nephrotic syndrome, pulmonary edema), hypertension, hypercalcemia Toxicity- Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis (interstitial), Gout |
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Ethacrynic acid
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Mechanism- Phenoxyacetic acid derivative (NOT SULFONAMIDE) but works the same as furosemide.
Use- Diuresis in patients who are allergic to sulfa drugs. Toxicity- Similar to furosemide |
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Hydrochlorothiazide
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Mechanism- Works in the DCT. Inhibits NaCl reabsorption, reducing the diluting capacity of the nephron, decreases calcium excretion.
Use- Hypertension, CHF (usually loop though), Idiopathic hypercalciuria, nephrogenic DI, nephrolithiasis secondary to hypercalciuria. Toxicity- Hypokalemic metabolic alkalosis, hyponatremia, hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia (HyperGLUC) |
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K-sparing diuretics: Spironolactone, Epleronone, Triamterene, Amiloride
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Mechanism- Spirinolactone is a competitive aldo receptor antagonist in the CCT. Triamterene and amiloride block ENaC at the CCT.
Use- Hyperaldosteronism, K-depletion, CHF (reduce M&M- spironolactone), PCOS (spironolactone) Toxicity- Hyperkalemia (arrhythmia), endocrine effects with spironolactone, acidemia |
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ACEI: Captopril, Enalapril, Lisinopril
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Mechanism- Inhibits ACE, reducing levels of AII and preventing inactivation of bradykinin (vasodilator). Renin release is increased because of loss of (-) FB
Use- HTN, CHF, DM renal disease (reduces proteinuria) Toxicity- Cough, Angioedema, Proteinuria, Taste changes, hypOtension, pregnancy problems (fetal renal damage), Rash, Increased renin, Lower AII (CAPTOPRIL). Also hyperkalemia. Need to avoid with bilateral renal artery stenosis because ACEI lower GFR by preventing constriction of the efferent arterioles. |
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ARBs: Losartan
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Mechanism- AII receptor antagonist. Does NOT cause cough or angioedema like ACEI!
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