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CVRR 73 Diuretics


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Diuretics
Drugs which increase the excretion of Na+ and water by the kidney
Carbonic anhydrase inhibitors, Loop, thiazide
The 5 types of diuretics. [______], [______], [______], potassium sparing and osmotic.
Potassium sparing and osmotic
The 5 types of diuretics. Carbonic anhydrase inhibitors, Loop, thiazide, [______] and [______]
Acetazolamide
Example of a carbonic anhydrase inhibitor diuretic
Sickness and glaucoma
Carbonic anhydrase inhibitors can inhibit altitude [______] and [______]
Metabolic acidosis and alkaline urine
Side effects of carbonic anhydrase inhibitors
Loop diuretic
Diuretics that act on the ascending loop of Henle in the kidney
Frusemide
Example of a Loop diuretic
Loop
Inhibition of Na+/K+/2Cl- triple symporter of the thick ascending limb is the site of action for [______] diuretics
15-20
Loop diuretics can excrete up to [__-__]% of filtered Na+
25
Loop diuretics can excrete up to [__]% of GFR
Hypovolaemia and hypokalaemia
Potential problems of Loop diuretics
1 hour
Oral onset of action time for Loop diuretics
30 minutes
IV onset of action time for Loop diuretics
6 hours
Maximum time of effective action of Loop diuretics
Hydrochlorothiazide
Example of a thiazide diuretic
Thiazide
Diuretics that act on the distal convoluted tubule in the kidney
Hypokalaemic alkalosis
Potential problem of thiazide diuretics
Gout and hyperuricaemia
Two possible complications resulting from competition between thiazide diuretics and uric acid for organic acid transport system across membrane
1-2 hours
Oral administration onset of action for thiazide diuretic
12-24 hours
Time of effective action of thiazide diuretics
Potassium sparing
Late distal tubule and collecting duct are the sites of action for [______] diuretics
Potassium sparing
1) Blockade of Na+ channel in principle cell and 2) aldosterone antagonist are the mechanisms of two groups of [______] diuretics
Triamterene
An example of a Na+ channel blocking potassium sparing diuretic
Spironolactone
An example of an aldosterone antagonist potassium sparing diuretic
Hyperkalaemia
Potassium sparing diuretics are usually administered alongside other diuretics, as they can lead to [______] on their own
Mannitol
Example of an osmotic diuretic
Osmotic
All segments of the nephron where water absorption occurs by osmosis are sites of action for [______] diuretics
Osmotic
[_____] diuretics are not reabsorbed, preventing water from being reabsorbed
Osmotic
[_______] diuretics are used to reduce ECF, renal dysfunction (eg. nephrotic syndrome), heart failure and hypertension
FALSE
Diuretics are the first-line treatment of chronic systolic heart failure
Digoxin
A drug used historically to treat chronic heart failure - discontinued because it did not reduce mortality
Claptopril, cilazapril and enalapril
Three examples of ACE inhibitors
ACE inhibitors
All drugs ending in '-pril' are [______]
Loop diuretic
A type of diuretic used if patient's renal function is impaired (GFR less that 30mL/min)
Hyponatraemia and hypokalaemia
A complication caused by both thazide and loop diuretics. Thiazide also causes HYPERcalcaemia and Loop causes HYPOcalcaemia