Cardio Pharm II

Drug that increase the excretion of H2O and Na+/Cl- through the kidneys, helping to reduce blood pressure and manage edema.

Diuretic

A sustained imbalance of Na+/Cl- could lead to

Too much = volume overload (pulmonary edema)

Too little = volume depletion (CV collapse)

What renal compensatory mechanisms prevent volume depletion?

• Activation of SNS and RAAS

What is the mechanism of action of loop diuretics?

Inhibit Na+-K+Cl- cotransporter in thick ascending loop → increased excretion of NaCl & H2O

Name 2 key adverse effects of loop diuretics

• hypokalemia

• ototoxicity

What are the main therapeutic uses of loop diuretics?

• pulmonary edema

• CHF

• renal failure

• cirrhosis

• hypercalcemia

• HTN

What metabolic side effects are common with thiazides?

• hyperglycemia

• hyperuricemia

• hyperlipidemia

What is a key clinical pearl about thiazides in renal disease?

Ineffective in patients with GFR < 30-40 mL/min (except metolazone)

• Inhibit NaCl reabsorption, increasing urine output

• Increase K+ excretion

• Incease Ca2+ & Mg2+ excretion

Major actions of loop diuretics

Which diuretics are effective in patients with CrCl below 30 mL/min?

Loop diuretics