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Questions and Answers
What percentage of filtered sodium do loop diuretics typically eliminate?
What percentage of filtered sodium do loop diuretics typically eliminate?
20-25%
Name three loop diuretics that share the same molecular target and effects.
Name three loop diuretics that share the same molecular target and effects.
Furosemide (Lasix), Bumetanide, and Piretanide.
What specific cotransporter in the ascending limb of Henle's loop is blocked by loop diuretics?
What specific cotransporter in the ascending limb of Henle's loop is blocked by loop diuretics?
Na/K/2Cl cotransporter
What effect does the inhibition of the Na/K/2Cl cotransporter have on the urinary excretion of electrolytes?
What effect does the inhibition of the Na/K/2Cl cotransporter have on the urinary excretion of electrolytes?
In which patient population are loop diuretics particularly useful, contrasting with thiazide diuretics?
In which patient population are loop diuretics particularly useful, contrasting with thiazide diuretics?
For what primary condition are loop diuretics used due to their powerful diuretic effect?
For what primary condition are loop diuretics used due to their powerful diuretic effect?
Under what hypercalcemia circumstances might loop diuretics be indicated?
Under what hypercalcemia circumstances might loop diuretics be indicated?
In essential hypertension (HTA), when are loop diuretics generally not used?
In essential hypertension (HTA), when are loop diuretics generally not used?
The reabsorption of what two ions is indispensable to the generation of a transepithelial difference of 10mV?
The reabsorption of what two ions is indispensable to the generation of a transepithelial difference of 10mV?
What normally reabsorbs 1Na, 1K, and 2Cl in the ascending limb of Henle?
What normally reabsorbs 1Na, 1K, and 2Cl in the ascending limb of Henle?
Flashcards
Loop Diuretics
Loop Diuretics
Diuretics that act on the renal tree and eliminate 20-25% of filtered sodium. They block the Na/K/2Cl cotransporter in the ascending limb of Henle.
Examples of Loop Diuretics
Examples of Loop Diuretics
Furosemide (Lasix), Bumetanide, and Piretanide
Indications for Loop Diuretics
Indications for Loop Diuretics
To induce a significant diuresis for treating edema (cardiac, renal, or hepatic origin), acute heart failure with pulmonary edema, and certain types of hypercalcemia.
Use in Hypertension
Use in Hypertension
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Sodium Reabsorption in the kidney
Sodium Reabsorption in the kidney
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Study Notes
- As part of antihypertensive treatments, diuretics act on the renal tree.
- Sodium in plasma is filtered 100% at the glomerulus, and reabsorbed along the renal tree.
- Reabsorption occurs mainly (30-40%) in the proximal convoluted tubule (PCT), 10-25% in the ascending limb of Henle, and 5-10% in the distal tubule and collecting duct.
- The most used compounds are thiazides > potassium-sparing diuretics > loop diuretics (very potent).
Loop Diuretics
- Eliminate 20-25% of filtered sodium, making them the most potent, inducing sodium (and water) elimination.
- Medications include Furosemide (Lasix), Bumetanide, and Piretanide, sharing molecular targets and effects.
- They inhibit the Na/K/2Cl cotransporter in the ascending limb of Henle.
- This cotransporter normally reabsorbs 1Na, 1K, and 2Cl.
- Once inside the cells, ions are taken up by systems in the bloodstream for elimination, including Na/K-ATPase and Cl channels.
- They originate from a transepithelial difference of 10mV, which is essential for Mg and Ca reabsorption at tight junctions.
- Inhibition of this transporter leads to increased urinary elimination of Na, K, Cl, Mg, Ca, and water.
- Loop diuretics are effective in patients with renal failure, unlike thiazides.
Indications for Loop Diuretics
- Used for their diuretic properties in treating edemas of cardiac, renal, or hepatic origin, as well as in acute heart failure with pulmonary edema, and certain types of hypercalcemia.
- Not generally used in the treatment of essential hypertension, except in patients with compromised renal function.
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