Peters Exam 1- Diurectics, Sympatholytics

Mannitol MOA

Osmotic Diuretic -

Osmolyte→Draws water out of Intracellular space into extracellular place

Small enough to be filtered by glomerulus, but can't be reabsorbed which traps water

Acts at proximal tubule, loop of henle and collecting duct

Mannitol delviery

IV- too polar to be taken PO

Mannitol Uses

Acute settings to force fluid through kidneys

Mannitol AE

Headache

Loss of potassium

Furosemide

Loop diuretic-

Inhibits NA+/K+/Cl- transporter in ascending limb in loop of henle→ Causes increased excretion of water and sodium, and Mg and Ca are excreted at higher rates

Furosemide uses

Hypertension

Congestive heart failure

Liver cirrhosis

Renal Failure

Hypercalcemia

Furosemide AEs

Hypokalemia

Alkalosis

Low blood pressure

Gout

Hearing defects (can be reversed once discontinued)

Thiazide MOA

Thiazide diuretics-

Inhibits NaCl co transporter in distal tubule- prevents reabsorption of Na+

Make urine less diluted

Can be paired w low salt diet to increase effect

Thiazide uses

Hypertension

Liver cirrhosis

Congestive heart failure

Hypercalciuria(kidney stones)

Increase Ca reabsorption

Thiazide AEs

Hypokalemia

Alkalosis

Potassium sparing diuretics

Spironolactone

Amiloride

Spironolcatone MOA

Aldosterone antagonist

Amiloride MOA

Sodium channel blocker selective for the tubule

Potassium Sparing diuretics uses

Primary hyperaldosteronism

Blocks AEs of other diuretics by retaining K+ and H+

Congestive heart failure

Liver cirrhosis

Spironolactone: acne in women

Potassium Sparing diuretics AEs

Hyperkalemia

Spironolactone- gynecomastia (breast increase in men)

Types of sympatholytics

Centrally Acting Sympatholytics

Peripherally Acting Sympatholytics

Adrenergic Antagonists- Alpha Blockers

Adrenergic Antagonists- Beta Blockers

Centrally Acting Sympatholytics

Clonidine

Clonidine MOA

Centrally Acting Sympatholytics -

Alpha 2 agonist : reduces symp activity lowering TPR and CO

Clonidine Uses

Primary hypertension

Clonidine AEs

Sedation

Depression

Rebound hypertension when discontinued

Peripherally Acting Sympatholytics

Guanethidine

Reserpine

Guanethidine MOA

Peripherally Acting Sympatholytics -

Displacement of NE and inhibition of release

Reserpine MOA

Peripherally Acting Sympatholytics -

Depletion of catecholamines (ie, NE, Dopamine)

Peripherally Acting Sympatholytics Uses

Treat hypertension- Low cost

Reserpine AEs

Crosses BBB causing concentration difficulty and depression

Prazosin MOA

Adrenergic Antagonists- Alpha Blockers

Alpha 1 antagonist- prevent blood vessel constriction

Prazosin use

Hypertension

Prazosin AEs

Dizziness

Lack of energy

Drowsiness

*First dose has biggest effect, usually taken before bed

Propranolol MOA

Adrenergic Antagonists- Beta Blockers

B1&2 antagonist - reduces CO & reduces TPR

Blocks SNS at B1 in juxtaglomerular cells

Indirect reduction @ angiotensin ii causes vasodilation

Propanolol uses

Hypertension

Propanolol AEs

Asthma (B2 blocking on lungs)

Worses high cholesterol

Depression

Rebound hypertension