Diuretics

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Questions and Answers

Which diuretic's mechanism of action primarily involves inhibiting the Na+ K+ cotransporter in the ascending loop of Henle?

  • Furosemide (correct)
  • Spironolactone
  • Acetazolamide
  • Hydrochlorothiazide

A patient with glaucoma is prescribed a diuretic. Which of the following diuretics would be most appropriate, considering its mechanism of action and indication?

  • Hydrochlorothiazide
  • Amiloride
  • Acetazolamide (correct)
  • Furosemide

A patient is experiencing hypokalemia as a side effect of diuretic use. Which diuretic is most likely contributing to this electrolyte imbalance?

  • Spironolactone
  • Amiloride
  • Furosemide (correct)
  • All of the above

Which diuretic's mechanism of action is primarily antagonizing aldosterone?

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

Which diuretic is most likely to cause hyperkalemia?

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

A patient presents with erectile dysfunction after starting a diuretic. Which diuretic is most likely contributing to this side effect?

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

Which of the following diuretics is contraindicated in individuals with hepatic coma?

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

A patient with a history of gout is prescribed a diuretic for hypertension. Which diuretic should be avoided due to its potential to exacerbate gout?

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

Which diuretic works in the early part of the distal tubule to inhibit NaCl cotransporter?

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

A patient with diabetes insipidus is prescribed a diuretic. Which of the following diuretics is indicated for the management of diabetes insipidus?

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

Which diuretic is most likely to cause metabolic acidosis as a side effect?

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

A patient presents with gynecomastia after being prescribed a diuretic. Which of the following diuretics is most likely contributing to this side effect?

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

Which of the following diuretics is contraindicated in patients with anuria?

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

Which diuretic is known to cause photosensitivity as a side effect?

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

A patient is prescribed a diuretic to prevent hypokalemia. Which of the following diuretics is most appropriate for this indication?

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

Which diuretic's primary mechanism of action involves inhibiting carbonic anhydrase enzyme?

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

A patient with hyperlipidemia is prescribed a diuretic for hypertension. Which diuretic should be used cautiously due to its potential to worsen hyperlipidemia?

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

Which diuretic reduces peripheral resistance by vasodilation?

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

A pregnant patient requires a diuretic. Which of the following diuretics is generally contraindicated during pregnancy?

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

Which condition is NOT an indication for Furosemide prescription?

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

Which is NOT a side effect of Hydrochlorothiazide?

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

Which agent has the greatest diuretic effect?

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

Which diuretic is least likely to be administered alone?

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

Which diuretic is NOT normally used in hypertension?

<p>All of the options are used in hypertension. (D)</p> Signup and view all the answers

Which of the following diuretics is most likely to cause GI upset as a side effect?

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

Which diuretic has the potential side effect of menstrual irregularities?

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

If a patient needs a diuretic but also has a renal insufficiency, which of these diuretics should be avoided?

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

Which diuretic should be avoided in patients with a sulfa allergy?

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

If a patient needs a diuretic urgently to remove water, which is the best option?

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

A patient prescribed a diuretic is suffering from hypovolemia, which drug could be the cause?

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

Which diuretic is known for retaining Bicarbonate in the Lumen?

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

Which agent will increase calcium reabsorption?

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

Which of these drugs does block the Na+ channel?

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

Which agent has the weakest effect?

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

Which of these drugs is known to inhibit Na+ reabsorption?

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

Which of these drugs decreases the reabsorption of Na+ in the proximal tubule?

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

A patient with Congestive Heart Failure (CHF) is prescribed a diuretic. Which agent is least likely to be appropriate for this indication?

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

What is the primary mechanism of action for Amiloride?

<p>Blockage of sodium channels in the collecting tubule (D)</p> Signup and view all the answers

A patient with pre-existing hyperkalemia requires a diuretic. Which of the following conditions would contraindicate the use of spironolactone in this patient?

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

A patient taking a diuretic is experiencing increased bicarbonate retention. Which of the following diuretics is most likely responsible for this side effect?

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

A patient with a known hypersensitivity to sulfa drugs requires a diuretic. Which of the following would be the safest option?

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

A patient presents with hypokalemia and metabolic acidosis. Which of the following diuretics is most likely contributing to these electrolyte imbalances?

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

Which diuretic is LEAST likely to be useful in treating hypertension in a patient with a history of gout?

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

Flashcards

Diuretics

Diuretics are a class of drugs that promote increased urine production.

Acetazolamide MOA

Acetazolamide inhibits carbonic anhydrase, reducing Na+ reabsorption in the proximal tubule.

Acetazolamide Side Effects

Acetazolamide can lead to hypokalemia and metabolic acidosis.

Acetazolamide Indications

Acetazolamide is used to treat hypertension, glaucoma and congestive heart failure.

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Acetazolamide Contraindications

Acetazolamide is contraindicated in patients with hypokalemia, metabolic acidosis, renal insufficiency or during pregnancy.

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Furosemide MOA

Furosemide inhibits the Na+/K+/2Cl- cotransporter in the ascending loop of Henle, causing a potent diuretic effect.

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Furosemide Side Effects

Common side effects of Furosemide include hypovolemia, hyperuricemia, hypokalemia, and hypocalcemia.

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Furosemide Indications

Furosemide is indicated for the treatment of hypertension, liver cirrhosis, congestive heart failure and renal disease.

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Furosemide Contraindications

Contraindications for Furosemide include anuria, hypokalemia, hypocalcemia, hepatic coma, and pregnancy.

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Hydrochlorothiazide Site of Action

Hydrochlorothiazide inhibits NaCl reabsorption in the early part of the distal tubule.

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Hydrochlorothiazide Indications

Hydrochlorothiazide is used for hypertension and diabetes insipidus.

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Spironolactone MOA

Spironolactone antagonizes aldosterone in the collecting tubule, promoting Na+ excretion and K+ retention.

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Spironolactone Side Effects

Side effects of Spironolactone can include hyperkalemia, metabolic acidosis, GI upset, gynecomastia and menstrual irregularities.

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Spironolactone Indications

Spironolactone is used for congestive heart failure, liver failure and to prevent hypokalemia.

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Spironolactone Contraindications

Spironolactone is contraindicated in patients with anuria, renal insufficiency, hyperkalemia, and during pregnancy.

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Torsemide

Torsemide is a loop diuretic with a greater diuretic effect and removes water to reduce peripheral resistance.

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Indapamide

Indapamide is a thiazide-like diuretic commonly used to treat hypertension.

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Chlorothiazide

Chlorothiazide is a thiazide diuretic with weak effects that also causes vasodilation.

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Amiloride

Amiloride is a potassium-sparing diuretic that blocks Na+ channels in collecting duct.

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K+ sparing diruetics SE

Hyperkalemia is a potential side effect of potassium-sparing diuretics.

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Loop Diuretics MOA

Loop diuretics inhibit the Na+/K+/2Cl- cotransporter in the ascending limb of the loop of Henle, leading to significant sodium and water excretion.

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Thiazides and Calcium

Thiazides increase calcium reabsorption.

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Hydrochlorothiazide Side Effects

Erectile dysfunction can occur as a side effect of Hydrochlorothiazide.

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Diabetes insipidus and Hydrochlorothiazide

Diabetes insipidus can be treated with Hydrochlorothiazide.

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Study Notes

  • Diuretics are a group of drugs.

Carbonic Anhydrase Inhibitors

  • Agent: Acetazolamide.
  • MOA: Affects electrolyte composition (EC) by decreasing NaCl, NaHCO3, and K+ levels.
  • MOA: Inhibits the carbonic anhydrase enzyme.
  • MOA: Leads to bicarbonate retention in the lumen and reduces sodium reabsorption in the proximal tubule.
  • Side Effects: Hypokalemia and metabolic acidosis.
  • Indication: Used for hypertension, glaucoma, and congestive heart failure.
  • Contraindications: Include hypokalemia, metabolic acidosis, renal insufficiency, and pregnancy.

Loop Diuretics

  • Agents: Furosemide and Torsemide (listed as having the greatest diuretic effect).
  • MOA: These impact electrolyte composition by decreasing NaCl, K+, and Ca2+ in the ascending loop of Henle.
  • MOA: They inhibit the Na+ K+ cotransporter, producing a substantial diuretic effect and reduce peripheral resistance by removing water.
  • Side Effects: Can cause hypovolemia, hyperuricemia, hypokalemia, and hypocalcemia.
  • Indication: Used for hypertension, liver cirrhosis, congestive heart failure, and renal disease.
  • Contraindications: Include anuria, hypokalemia, hypocalcemia, hepatic coma, and pregnancy.

Thiazides

  • Agents: Hydrochlorothiazide (most common), Indapamide, and Chlorothiazide (weak diuretic).
  • MOA: Affect electrolyte composition by increasing Ca2+ and decreasing Na+, Mg2+, K+, and NaCl, work in the early part of the distal tubule
  • MOA: Promote NaCl excretion by inhibiting the NaCl cotransporter and cause vasodilation to reduce SVR.
  • Side Effects: May result in hypokalemia, hyperuricemia, hypercalcemia, hyperlipidemia, photosensitivity, and erectile dysfunction.
  • Indication: Used for hypertension, heart failure, and diabetes insipidus.
  • Contraindications: Include gout, diabetes, hyperlipidemia, hypokalemia, and pregnancy.

K+-Sparing Agents

  • Agents: Amiloride and Spironolactone, often used with other diuretics and are considered weak.
  • MOA: Affect electrolyte composition by increasing K+ and decreasing NaCl and NaHCO3 in the collecting tubule.
  • MOA: They inhibit Na+ reabsorption and K+ excretion, with Amiloride blocking Na+ channels and Spironolactone antagonizing Aldosterone.
  • Side Effects: Can lead to hyperkalemia, metabolic acidosis, GI upset, gynecomastia (with spironolactone), and menstrual irregularities.
  • Indication: Used for congestive heart failure, liver failure, and to prevent hypokalemia.
  • Contraindications: Include anuria, renal insufficiency, hyperkalemia, and pregnancy.

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