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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