Podcast
Questions and Answers
Which diuretic class primarily acts within the proximal convoluted tubule (PCT) by inhibiting carbonic anhydrase?
Which diuretic class primarily acts within the proximal convoluted tubule (PCT) by inhibiting carbonic anhydrase?
- Carbonic Anhydrase Inhibitors (correct)
- Thiazide Diuretics
- Loop Diuretics
- Potassium-Sparing Diuretics
Loop diuretics enhance the reabsorption of calcium and magnesium in the kidneys.
Loop diuretics enhance the reabsorption of calcium and magnesium in the kidneys.
False (B)
What is the primary mechanism of action of thiazide diuretics in the distal convoluted tubule (DCT)?
What is the primary mechanism of action of thiazide diuretics in the distal convoluted tubule (DCT)?
Inhibition of the Na+/Cl- transporter
Acetazolamide, a carbonic anhydrase inhibitor, is used to reduce intraocular pressure in the treatment of ______.
Acetazolamide, a carbonic anhydrase inhibitor, is used to reduce intraocular pressure in the treatment of ______.
Match the diuretic with its primary site of action in the nephron:
Match the diuretic with its primary site of action in the nephron:
Which side effect is most commonly associated with carbonic anhydrase inhibitors due to excessive bicarbonate loss?
Which side effect is most commonly associated with carbonic anhydrase inhibitors due to excessive bicarbonate loss?
Ethacrynic acid, a loop diuretic, increases calcium reabsorption in the kidneys.
Ethacrynic acid, a loop diuretic, increases calcium reabsorption in the kidneys.
What electrolyte imbalance, besides hypokalemia, is a common side effect of chronic loop diuretic use?
What electrolyte imbalance, besides hypokalemia, is a common side effect of chronic loop diuretic use?
Thiazide diuretics are sometimes prescribed to prevent kidney stones because they enhance the reabsorption of ______ in the kidneys.
Thiazide diuretics are sometimes prescribed to prevent kidney stones because they enhance the reabsorption of ______ in the kidneys.
A patient with a known sulfonamide allergy should use caution as a contraindication to which class of diuretics?
A patient with a known sulfonamide allergy should use caution as a contraindication to which class of diuretics?
Flashcards
Carbonic Anhydrase Inhibitors
Carbonic Anhydrase Inhibitors
Diuretics that inhibit carbonic anhydrase in the proximal convoluted tubule, leading to increased NaHCO3 excretion.
Loop Diuretics
Loop Diuretics
Diuretics that inhibit the Na+/K+/2Cl− transporter in the thick ascending limb, decreasing NaCl reabsorption.
Thiazide Diuretics
Thiazide Diuretics
Diuretics that inhibit the Na+/Cl− transporter in the distal convoluted tubule, increasing Ca2+ reabsorption.
Potassium-Sparing Diuretics
Potassium-Sparing Diuretics
Signup and view all the flashcards
Acetazolamide
Acetazolamide
Signup and view all the flashcards
Furosemide
Furosemide
Signup and view all the flashcards
Hydrochlorothiazide
Hydrochlorothiazide
Signup and view all the flashcards
Hypokalemic Metabolic Alkalosis
Hypokalemic Metabolic Alkalosis
Signup and view all the flashcards
Ototoxicity
Ototoxicity
Signup and view all the flashcards
Gout Triggers
Gout Triggers
Signup and view all the flashcards
Study Notes
Diuretic Overview
-
Carbonic Anhydrase Inhibitors (CAIs):
- Examples: Acetazolamide, Dorzolamide, Brinzolamide
- MOA: Inhibit carbonic anhydrase in the proximal convoluted tubule, decreasing HCO3− reabsorption, leading to urine alkalinization.
- Uses: Glaucoma (lowers intraocular pressure), urinary alkalinization (promotes acidic drug excretion), acute mountain sickness (reduces CSF formation), epilepsy (adjunct), CSF leakage (decreases CSF production).
- Side Effects: Hyperchloremic metabolic acidosis, renal stones (phosphaturia), drowsiness, paresthesias, hypersensitivity reactions.
- Contraindications: Cirrhosis, renal failure.
-
Loop Diuretics:
- Examples: Furosemide, Bumetanide, Torsemide, Ethacrynic acid
- MOA: Inhibit Na+/K+/2Cl− transporter in the thick ascending limb, decreasing NaCl reabsorption, enhancing Ca2+ and Mg2+ excretion.
- Uses: Hypertension, edema (heart failure, pulmonary edema, cirrhosis), hyperkalemia, acute renal failure, anion overdose.
- Side Effects: Hypokalemic metabolic alkalosis, ototoxicity, hyperuricemia, hypomagnesemia.
- Contraindications: Gout, hepatic cirrhosis, heart failure, borderline renal failure.
-
Thiazide Diuretics:
- Examples: Hydrochlorothiazide, Chlorthalidone, Indapamide, Metolazone
- MOA: Inhibit Na+/Cl− transporter in the distal convoluted tubule, increasing Ca2+ reabsorption (compared to loop diuretics). Mild diuretic effect.
- Uses: Hypertension, heart failure, nephrolithiasis, nephrogenic diabetes insipidus, osteoporosis prevention.
- Side Effects: Hypokalemic metabolic alkalosis, hyponatremia, hyperglycemia, hyperlipidemia, hyperuricemia.
- Contraindications: Severe renal impairment, sulfonamide allergy, gout.
-
Potassium-Sparing Diuretics:
- Examples: Spironolactone, Eplerenone, Amiloride, Triamterene
- MOA: Spironolactone/Eplerenone antagonize aldosterone, Amiloride/Triamterene block epithelial Na+ channels (ENaC).
- Uses: Hyperaldosteronism, combination therapy (prevents K+ loss from other diuretics).
- Side Effects: Hyperkalemia, gynecomastia (spironolactone), metabolic acidosis.
- Contraindications: Chronic renal insufficiency, K+ supplements, liver disease, CYP3A4 inhibitors.
Key Differences and Considerations
- Uric Acid: Loop and thiazide diuretics can increase uric acid levels, making them unsuitable for people with gout.
- Calcium: Loop diuretics cause hypocalcemia, while thiazides cause hypercalcemia.
- Strength: CAIs are relatively weak diuretics, primarily used for specific conditions.
- Potassium: Potassium-sparing diuretics pose a risk of hyperkalemia, especially in those with renal issues.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
This lesson covers the use of diuretics such as Carbonic Anhydrase Inhibitors and Loop Diuretics. It includes mechanisms of action, examples of drugs in each class, uses, side effects, and contraindications. Examples include Acetazolamide, Dorzolamide, Furosemide, and Bumetanide.
