Pharmacology Chapter 22 Diuretic Drugs

Antidiuretic Hormone or Vasopressin produce _____ urine by increasing what

concentrated (less water)

Water permeability and reabsorption

Caffeine, Alcohol, and Water are common _____ agents

diuretic

In the loop of Henle

The descending limb is _____ to water

The ascending limb is _____ to water

permeable

impermeable

Drug

The 2 types of K+ sparing diuretics are

Aldosterone _____

Na channel _____

Antagonist

Blocker

Drug

Spironolactone

Amiloride

Triamterene

Spironolactone: Aldosterone Antagonist

Amiloride: Na channel blocker

Triamterene: Na channel blocker

What drug are taken together to prevent hypokalemia?

Loop and Thiazide diuretics combined with K+ sparing diuretics

K+ sparing alone only causes mild natriuretic effect

K+-sparing diuretics are most often used to prevent _____ caused by thiazide and loop diuretics.

_______ is also sometimes used in treatment of hyperaldosteronism

hypokalemia

Spironolactone

Plasma _______ concentration is inappropriately elevated in patients with congestive heart failure, and it contributes to the development of edema, direct hypertrophic effects on the myocardium, and other adverse effects in heart failure.

What 2 drugs are useful to treat this?

aldosterone

Spironolactone and Eplerenone

The primary toxic effect of K+-sparing diuretics is _______

hyperkalemia

Thiazide diuretics work by ______ NaCl cotransport in the _____ nephron

In addition it increase reabsorption of filtered ____ and ____ loss

inhibiting, distal

Ca, Mg

Inhibit Salt absorption and water follows salt

Inhibitors of _____ _____ transport, such as ______, can inhibit the action of thiazide diuretics by lowering the luminal concentration.

organic acid, probenicid

_____ sodium level can cause hyponatremia which causes systemic cellular edema and brain swelling

Low

Thiazide diuretic also interferes with ______ transport which can cause gout

urate

______ diuretics inhibits NaCl cotransport in the distal nephron

______ diuretics inhibit NaCl reabsorption at the ascending limb

Thiazide

Loop

4 Loop Diuretics to know

Furosemide

Bumetanide (faster)

Torsemide

Ethacrynic acid (loop diuretic not a sulfonamide)

Loop diuretics are predominantly used to treat _____

edema

______ diuretics increase Ca reabsorption

______ diuretics decrease Ca reabsorption

Thiazide

Loop

Drug

Acetazolamide is what class

Used to treat

Carbonic Anhydrase Inhibitors

Earliest diuretics

Glaucoma and Epilepsy

Osmotic Diuretcs (______) work by increasing the ______ of the extracellular space causing water to move out instead of blocking transporter

Mannitol, osmolality

Mannitol is a ______ diuretic

Used to treat edema, glaucoma, and maintain urien flow

osmotic

Natriuretics vs ADH blockers

Natriuretics increase excretion of sodium

ADH blocker block V2 receptor and prevent water reabsorption

Conivaptan and tolvaptan are metabolized by ________ enzymes in the liver

Cytochrom P450

Conivaptan and tolvaptan are metabolized by Cytochrome P450 similar to many other drug which can cause dangerous drug interactions

_______ is also IV and only be used in hospital

Conivaptan

Epinephrine in local anesthetics or gingival retraction cords can cause _______ and increase risk of cardiac ______

hypokalemia, arrhythmias

Adrenocorticosteroids with anti-inflammatory dosages can promote ______, especially when used with diuretics

hypokalemia

Pt using K+ sparing diuretics or supplement should be cautious with ____ diet as many fruit and vegetables are high in _______

soft, potassium

Syncope can be caused by ______ and _____ in the presence of diuretics

sedative, opioid

_______ can reduce effectiveness of diuretics especially in pt with congestive heart failure due to impaired ________ synthesis

NSAIDS, prostaglandin

Most diuretics are in pregnancy class ____, meaning that there is a proven risk of fetal harm

D