Diuretic Drugs
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Questions and Answers

Which of the following drugs is classified as a potassium-sparing diuretic?

  • Spironolactone (correct)
  • Furosemide
  • Bumetanide
  • Hydrochlorothiazide

What process is primarily increased by diuretic drugs?

  • Sodium reabsorption
  • Solute secretion
  • Urine volume (correct)
  • Blood filtration rate

Which term refers to the increased excretion of sodium due to diuretic action?

  • Aquaretic
  • Reabsorption
  • Filtration
  • Natriuresis (correct)

Where in the nephron do thiazide diuretics primarily exert their effect?

<p>Distal convoluted tubule (A)</p> Signup and view all the answers

What is the mechanism of action for loop diuretics such as furosemide?

<p>Inhibition of Na-K-2Cl co-transporter in the thick ascending limb (A)</p> Signup and view all the answers

Which drug is primarily categorized as an osmotic diuretic?

<p>Mannitol (A)</p> Signup and view all the answers

Which side effect is commonly associated with potassium-sparing diuretics?

<p>Gynecomastia (C)</p> Signup and view all the answers

Which class of diuretics inhibits sodium reabsorption specifically in the proximal convoluted tubule (PCT)?

<p>Carbonic anhydrase inhibitors (C)</p> Signup and view all the answers

In which scenario would vasopressin administration likely be beneficial?

<p>Diabetes insipidus (C)</p> Signup and view all the answers

Which of the following drugs is an antagonist at aldosterone receptors?

<p>Spironolactone (B)</p> Signup and view all the answers

What is the mechanism of action for SGLT inhibitors?

<p>Inhibit sodium/glucose transporters in the PCT (D)</p> Signup and view all the answers

What primary effect does vasopressin have when it binds to V2 receptors?

<p>Increase water reabsorption (C)</p> Signup and view all the answers

Which of the following describes a common use for intravenous mannitol?

<p>Reducing intracranial pressure (B)</p> Signup and view all the answers

Which diuretic primarily inhibits sodium and chloride reabsorption in the thick ascending limb (TAL) of the nephron?

<p>Loop Diuretics (D)</p> Signup and view all the answers

What physiological condition can be treated with Carbonic Anhydrase Inhibitors like acetazolamide?

<p>Acute Mountain Sickness (C)</p> Signup and view all the answers

Which statement is true about Sodium Glucose Cotransporter 2 (SGLT2) inhibitors?

<p>They prevent the reabsorption of glucose, increasing its levels in the urine. (D)</p> Signup and view all the answers

What is a common adverse drug reaction (ADR) associated with Loop Diuretics?

<p>Hypokalemia (C)</p> Signup and view all the answers

Which of the following is NOT a characteristic of Potassium-Sparing Diuretics?

<p>They promote the reabsorption of sodium. (C)</p> Signup and view all the answers

Which drug is a Carbonic Anhydrase Inhibitor used for urinary alkalinization and other clinical purposes?

<p>Acetazolamide (D)</p> Signup and view all the answers

What could be a serious consequence of using NSAIDs in patients with renal insufficiency?

<p>Inhibition of prostaglandin production leading to kidney failure (B)</p> Signup and view all the answers

Which diuretic type often raises plasma uric acid levels due to blocking its secretion?

<p>Thiazide Diuretics (B)</p> Signup and view all the answers

Which of the following diuretics is most effective at managing acute pulmonary edema?

<p>Loop Diuretics (D)</p> Signup and view all the answers

Which of the following correctly describes the mechanism of action of Nesiritide?

<p>It increases GFR and blunts sodium reabsorption. (C)</p> Signup and view all the answers

Match each word to its definition:

<p>diuresis = increase urine volume diuretic = drug that increases urine volume naturiuretic = increase in sodium (Na) excretion aquaretic = increase in excretion of solute-free water</p> Signup and view all the answers

Match each word to its description:

<p>solute = any dissolved ions, molecules etc. filtration = movement of solutes and water from blood into the lumen reabsorption = The removal (taking back) of solutes and water into blood secretion = Removal of solutes from blood back into lumen</p> Signup and view all the answers

Match each to its description

<p>Diuresis = Passage of large amounts of urine Autacoid = Bioactive substances produced within the kidney Carbonic Anhydrase (CA) Inhibitors = block reabsorption of NaHCO SGLT Inhibitors = inhibit Na/glucose transporter</p> Signup and view all the answers

Match each of the following to their actions

<p>Loop Diuretics = inhibit NaCl reabsorption Thiazide Diuretics = inhibit NaCl reabsorption K+ Sparing Diuretics = prevent K+ secretion by blocking aldosterone Osmotic Diuretics = absorb water and retain this water in the tubules</p> Signup and view all the answers

Match each to its description and location

<p>ADH Antagonists = excess ADH secretion causes water retention Carbonic Anhydrase (CA) Inhibitors = PCT SGLT Inhibitors = PCT Loop Diuretics = TAL</p> Signup and view all the answers

Match each to its location or corresponding drugs

<p>Thiazide Diuretics = DCT K+ Sparing Diuretics = mineralcorticoid receptors/ luminal membrane Carbonic Anhydrase (CA) Inhibitors = acetazolamide SGLT Inhibitors = dapagliflozin</p> Signup and view all the answers

Match each to its corresponding drugs

<p>Loop Diuretics = furosemide, ethacrynic acid, bumetanide, torsemide Thiazide Diuretics = hydrochlorothiazide, metolazone K+ Sparing Diuretics = spironolactone, eplerenone, miloride,nesiritide, Osmotic Diuretics = mannitol</p> Signup and view all the answers

Which of the following is not an ADH antagonist drug?

<p>dapagliflozin (C)</p> Signup and view all the answers

Match each renal autacoid to its description

<p>= Adenosine = ribonucleoside Prostaglandins = required for normal kidney function Peptides = natriuretic peptides</p> Signup and view all the answers

Which renal autacoid is a peptide that increases GFR and blunts Na+ reabsorption?

<p>Nesiritide (A)</p> Signup and view all the answers

What can cause a rise in adenosine production in the kidneys by decreasing GFR and blood flow?

<p>Hypoxia (B)</p> Signup and view all the answers

What are carbonic anhydrase inhibitors derivatives of?

<p>sulfonamide (C)</p> Signup and view all the answers

Which of the following drugs is a Carbonic Anhydrase (CA) Inhibitor used for glaucoma?

<p>brinzolamide (D)</p> Signup and view all the answers

Which of the following is not an ADR of Carbonic Anhydrase (CA) Inhibitors?

<p>increased uric acid levels which can cause gout (B)</p> Signup and view all the answers

Which group of drugs requires potassium oral supplements with chronic dosing?

<p>Carbonic Anhydrase (CA) Inhibitors (D)</p> Signup and view all the answers

Which of the following is an adenosine A1 receptor antagonist that acts as a diuretic?

<p>Caffeine (B)</p> Signup and view all the answers

What are the most efficacious diuretic agents currently available?

<p>Loop Diuretics (A)</p> Signup and view all the answers

What do loop diuretics promote the excretion of?

<p>Calcium (A), Magnesium (B)</p> Signup and view all the answers

Match each drug group to its clinical uses

<p>Loop Diuretics = hypercalcemia; acute pulmonary edema Thiazides = hypertension; heart failure; kidney calcium stone formation; nephrogenic diabetes insipidus Osmotic Diuretics = intracranial and intraocular pressure Antidiuretic Hormone (ADH) and Vasopressin Agonists = Diabetes insipidus</p> Signup and view all the answers

Which of the following are antagonistic drugs to vasopressin? (Select all that apply)

<p>conivaptan (B), tolvaptan (A)</p> Signup and view all the answers

Where is vasopressin (ADH) released from?

<p>Posterior pituitary (B)</p> Signup and view all the answers

How is mannitol administered?

<p>IV (D)</p> Signup and view all the answers

Match each potassium-sparing diuretic to its mechanism of action (MOA):

<h1>nesiritide = increase GFR and blunt Na+ reabsorption</h1> <p>spironolactone; eplerenone = antagonist at mineralocorticoid receptors amiloride; triamterene = inhibit Na+ influx in luminal membrane</p> Signup and view all the answers

Which loop diuretic cannot cause a sulfa allergic reaction?

<p>Ethacrynic acid (C)</p> Signup and view all the answers

Which drugs have the following ADRs:

  • may block uric acid secretion and raise plasma uric acid levels
  • may elevate blood glucose levels
  • hyponatremia
  • sulfa allergic reactions possible?

<p>Thiazides (A)</p> Signup and view all the answers

What is the mechanism of action (MOA) of furosemide?

<p>Inhibition of sodium and chloride reabsorption in the ascending loop of Henle (A)</p> Signup and view all the answers

What electrolyte abnormalities can be caused by furosemide? (Select all that apply)

<p>Hypokalemia (A), Hypomagnesemia (C)</p> Signup and view all the answers

Which class of diuretics might be used IV to treat a severe case of hypercalcemia?

<p>Loop diuretics (B)</p> Signup and view all the answers

Which one of the following pairs is NOT correct?

<p>D (D)</p> Signup and view all the answers

Which of the following drugs are used to treat diabetes mellitus?

<p>dapagliflozin (A), canagliflozin (C)</p> Signup and view all the answers

Which of the following classes of drugs can increase uric acid levels, leading to gout?

<p>Loop Diuretics (D)</p> Signup and view all the answers

Which of the following is a rare and reversible adverse drug reaction (ADR) of loop diuretics?

<p>Ototoxicity (B)</p> Signup and view all the answers

What is GFR most often measured by?

<p>Creatinine Clearance (A)</p> Signup and view all the answers

Which of the following is an ADR of osmotic diuretics?

<p>Pulmonary edema (A)</p> Signup and view all the answers

Flashcards

Diuresis

An increase in the volume of urine produced by the kidneys.

Diuretic

A drug that increases urine output by promoting fluid excretion from the body.

Natriuretic

A drug that increases the excretion of sodium (Na+) ions in urine, thereby promoting water excretion.

Aquaretic

A drug that increases the excretion of water without significantly affecting electrolyte concentrations.

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Filtration

The movement of solutes and water from the blood into the lumen of the nephron.

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Carbonic Anhydrase Inhibitors

A class of diuretics that block the reabsorption of sodium bicarbonate (NaHCO3) in the proximal convoluted tubule (PCT).

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Carbonic anhydrase

The enzyme responsible for converting carbon dioxide and water into carbonic acid in the proximal convoluted tubule (PCT).

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SGLT2 Inhibitor

A drug that inhibits the reabsorption of glucose in the proximal convoluted tubule (PCT) by blocking the sodium-glucose cotransporter 2 (SGLT2).

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Loop Diuretics

The most potent diuretic agents currently available. They inhibit the reabsorption of sodium chloride (NaCl) in the thick ascending limb (TAL) of the loop of Henle.

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Hydrochlorothiazide

A thiazide diuretic that inhibits the reabsorption of sodium chloride (NaCl) in the distal convoluted tubule (DCT).

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Potassium-Sparing Diuretics

These diuretics prevent potassium secretion by blocking the action of aldosterone at the mineralocorticoid receptors in the collecting duct.

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Aldosterone

A steroid hormone produced by the adrenal glands that promotes the reabsorption of sodium and water in the collecting duct.

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Adenosine

A ribonucleoside that increases in the kidney during hypoxia (lack of oxygen).

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Prostaglandins

A class of lipids that are critical for normal kidney function. Inhibition of their synthesis by NSAIDs can lead to kidney failure.

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Nesiritide

A natriuretic peptide that increases glomerular filtration rate (GFR) and reduces sodium reabsorption.

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What do Spironolactone and eplerenone do in the kidneys?

Spironolactone and eplerenone block the action of aldosterone at its receptors in the kidneys. This prevents potassium from being excreted, making them "potassium-sparing" diuretics.

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How do Amiloride and triamterene work?

Amiloride and triamterene block the sodium channel in the kidneys, preventing sodium reabsorption and leading to its excretion. They also prevent potassium secretion, making them "potassium-sparing" diuretics.

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What does Mannitol do in the kidneys?

Mannitol is an osmotic diuretic that draws water into the renal tubules, preventing its reabsorption back into the bloodstream, increasing urine production.

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What is the function of Vasopressin (ADH)?

Vasopressin (ADH) is a hormone released from the posterior pituitary gland when blood pressure drops. It binds to V1 receptors on blood vessels, causing constriction, and to V2 receptors in the kidneys, promoting water reabsorption, leading to higher blood pressure.

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How do Conivaptan and Tolvaptan work?

Conivaptan (IV) and tolvaptan (oral) are antagonists that block the action of vasopressin at V2 receptors in the kidneys, preventing water reabsorption from the tubules.

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What do Carbonic Anhydrase Inhibitors do?

Carbonic anhydrase inhibitors, like acetazolamide, block the reabsorption of sodium bicarbonate (NaHCO3) in the proximal convoluted tubule (PCT) of the kidney.

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What do Loop Diuretics do?

Loop diuretics, such as furosemide, ethacrynic acid, bumetanide, and torsemide, inhibit sodium chloride (NaCl) reabsorption in the thick ascending limb (TAL) of the loop of Henle.

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What do Thiazide diuretics do?

Thiazide diuretics, including hydrochlorothiazide, bendroflumethiazide, hydroflumethiazide, metolazone, and trichlormethiazide, inhibit sodium chloride (NaCl) reabsorption in the distal convoluted tubule ( DCT) of the kidney.

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Study Notes

Diuretic Drugs

  • Diuretics increase urine volume
  • Diuretic drugs increase urine volume
  • Natriuretic increases sodium excretion
  • Aquaretic increases excretion of solute-free water
  • Solute is any dissolved ions, molecules, etc.
  • PCT is proximal convoluted tubule
  • TAL is thick ascending limb
  • DCT is distal convoluted tubule
  • SGLT is sodium-glucose co-transporter
  • NaHCO₃ is sodium bicarbonate
  • GFR is glomerular filtration rate

Drug Classes and Actions

  • Carbonic Anhydrase (CA) Inhibitors: Block reabsorption of NaHCO₃ in the PCT
  • SGLT Inhibitors: Inhibit sodium/glucose transporter in the PCT
  • Loop Diuretics: Inhibit NaCl reabsorption in the TAL
  • Examples include: furosemide, bumetanide, torsemide, ethacrynic acid
  • Thiazide Diuretics: Inhibit NaCl reabsorption in the DCT
  • Examples include: hydrochlorothiazide, bendroflumethiazide, metolazone, chlorthalidone, trichlormethiazide
  • Potassium-Sparing Diuretics: Prevent potassium secretion by blocking aldosterone
  • Examples include: spironolactone, eplerenone, amiloride, triamterene

Other Terms

  • Diuresis: Increase in urine volume
  • Reabsorption: Removal of solutes and water from the tubules back into the blood
  • Secretion: Removal of solutes from the blood into the tubules

Clinical Uses

  • Diuretics are used to treat hypertension, heart failure, kidney calcium stone formation, and nephrogenic diabetes insipidus.
  • Some diuretics can be used to treat hypercalcemia and acute pulmonary edema, although it varies with specific diuretic drug.

Additional Information

  • Some diuretics are derived from sulfonamides (e.g., hydrochlorothiazide).
  • Certain diuretics have a sulfa group possibly causing allergic reactions in patients that are sensitive to sulfa drugs.
  • Caffein is an adenosine antagonist and can act as diuretic.
  • Some of the diuretic drugs are not derived from the sulfa group.
  • Ethacrynic acid is generally not associated with sulfa allergy.
  • Some diuretics cause significant potassium loss (e.g., loop and thiazide diuretics); potassium supplements may be necessary in such cases. hyperchloremic metabolic acidosis is a potential side effect.
  • Some diuretics can cause hyperkalemia and gynecomastia.
  • Osmotic diuretics (mannitol) are primarily used for increasing glomerular filtration rate and for reducing intracranial and intraocular pressure.

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PM 719 Pharmacology II Lecture Notes (LN) Chap 15 Diuretics PDF

Description

This quiz covers various classes of diuretic drugs and their mechanisms of action. You'll explore the specifics of how diuretics increase urine volume and the different types of diuretics, including loop, thiazide, and potassium-sparing diuretics. Test your knowledge on important terms and drug examples within this pharmacological topic.

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