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Questions and Answers
What is the primary mechanism by which diuretics lower blood pressure?
Which of the following is NOT a type of diuretic?
What is the most common initial drug therapy for hypertension?
Thiazide diuretics are ineffective in patients with what condition?
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What effect do diuretics have on blood volume in patients with hypertension?
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Which of the following side effects is associated with thiazide diuretics?
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For how long does the hypotensive effect of diuretics persist during long-term treatment?
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Which of the following diuretics can also be used in patients with impaired kidney function?
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What is the expected blood pressure reduction from diuretics in most patients?
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What should be monitored routinely in patients receiving diuretics?
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What condition is associated with thiazides' ineffectiveness?
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Which electrolyte disturbance is commonly caused by loop diuretics?
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What is a potential side effect of spironolactone and eplerenone?
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Which class of diuretics can be used to treat nephrogenic diabetes insipidus?
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How do loop diuretics affect renal blood flow?
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What adverse effect can result from the use of NSAIDs with thiazide diuretics?
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Which of the following loop diuretics is known for potentially causing hearing loss?
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What is a primary action of potassium-sparing diuretics?
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Study Notes
Types of Diuretics
- Thiazide Diuretics: Include Hydrochlorothiazide, Chlorothiazide, Chlorthalidone, Metolazone, and Indapamide.
- Loop Diuretics: Consist of Furosemide, Torsemide, Bumetanide, and Ethacrynic acid.
- Potassium-Sparing Diuretics: Comprised of Triamterene, Amiloride, Spironolactone, and Eplerenone.
Mechanism of Action
- Diuretics reduce blood volume, leading to lower blood pressure.
- Initial effects include decreased volume and cardiac output, followed by a decline in peripheral vascular resistance over time.
- Sodium retention affects vascular resistance by increasing vessel stiffness, which diuretics can reverse.
Efficacy and Usage
- Effective in lowering blood pressure by 10-15 mmHg in most patients.
- Thiazide diuretics can be first-line treatment unless contraindicated.
- In more severe hypertension, diuretics are combined with sympatholytic and vasodilator medications.
- Regular serum electrolyte monitoring is essential for all diuretic patients.
Thiazide Diuretics
- Effective in initial therapy by enhancing sodium and water excretion, which decreases extracellular volume.
- Long-term usage stabilizes plasma volume but maintains decreased peripheral resistance.
- Ineffective in patients with poor kidney function (eGFR < 30 mL/min/m²); loop diuretics become necessary.
- May induce hypokalemia, hyperuricemia, and in some cases, hyperglycemia and new-onset diabetes.
- Efficacy can be reduced with NSAIDs due to their effect on renal prostaglandins.
Loop Diuretics
- Prompt action in blocking sodium and chloride reabsorption makes them suitable for those with renal impairment.
- Enhance renal blood flow and decrease renal vascular resistance.
- Commonly used in heart failure and edema management rather than for hypertension alone.
- Potential side effects include hypokalemia, hyperuricemia, and possible reversible or permanent hearing loss when paired with ototoxic drugs.
Potassium-Sparing Diuretics
- Amiloride and Triamterene inhibit sodium reabsorption but have mild diuretic effects and can lead to hyperkalemia.
- Spironolactone and Eplerenone combat potassium loss and mitigate cardiac remodeling in heart failure.
- These agents possess antiandrogen properties, which may cause male sexual dysfunction and gynecomastia.
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Description
This quiz covers the various types of diuretics including thiazide, loop, and potassium-sparing diuretics. Gain insights into their common examples and uses in medical therapy, particularly for hypertension. Test your knowledge on these essential medications.
