PHARM 315 Chapter 1.1.3: Diuretics Overview

Questions and Answers

What is a characteristic of Open Angle Glaucoma?

The cornea becomes clouded and opaque.

Pressure in the eye is decreased.

The drainage angle between the iris and cornea is closed.

The drainage angle remains open, but drainage is impaired. (correct)

What is one of the primary uses of Mannitol?

To increase potassium levels.

To reduce cerebral edema. (correct)

To manage chronic kidney disease.

To treat severe hypertension.

Which of the following effects is associated with Mannitol use?

Marked increase in sodium excretion. (correct)

Increased retention of sodium and chloride.

Hypokalemic metabolic acidosis.

Decreased urine output.

What is the primary reason for using loop diuretics like Furosemide?

To manage acute edema. Signup and view all the answers

In which condition is Mannitol not typically indicated?

Chronic dehydration. Signup and view all the answers

What is the primary indication for osmotic diuretics?

Open-angle glaucoma treatment Signup and view all the answers

Which diuretic class is associated with metabolic alkalosis due to increased HCO3- levels?

Carbonic Anhydrase Inhibitors Signup and view all the answers

What is a common adverse effect associated with carbonic anhydrase inhibitors?

Sulfa-like hypersensitivity Signup and view all the answers

Which diuretic class would likely cause an accumulation of CO2 in patients with chronic obstructive pulmonary disease?

Carbonic Anhydrase Inhibitors Signup and view all the answers

How long does the diuretic effect of osmotic diuretics typically last?

72 hours Signup and view all the answers

What condition is categorized as catamenial seizures?

Seizures during the menstrual period Signup and view all the answers

What is a potential metabolic imbalance caused by the use of carbonic anhydrase inhibitors?

Metabolic Alkalosis Signup and view all the answers

Which of the following conditions is a contraindication for carbonic anhydrase inhibitors?

Liver disease Signup and view all the answers

Study Notes

Diuretics Overview

Diuretics are key antihypertensive agents affecting fluid balance and electrolyte levels.
They are classified into several categories, including carbonic anhydrase inhibitors, osmotic diuretics, loop diuretics, thiazide diuretics, and potassium-sparing diuretics.

Carbonic Anhydrase Inhibitors

Mechanism of Action: Inhibit carbonic anhydrase, increasing bicarbonate (HCO3-) in the blood; promotes HCO3- excretion in urine.
Associated with metabolic alkalosis (pH above 7.45).
Therapeutic Effects:
- Can lead to metabolic acidosis and hypersensitivity reactions similar to sulfa drugs.
Contraindications:
- Liver disease: risk of ammonia (NH3) accumulation, leading to alkaline imbalances.
- Chronic obstructive pulmonary disease: can cause respiratory and metabolic acidosis.

Osmotic Diuretics

Main agents: Acetazolamide, Brinzolamide, Dorzolamide.
Effects: Produce short-lived diuresis (lasting about 3 days), facilitate aqueous humor production.
Primary Use: Management of open-angle glaucoma due to improper drainage, not primarily for hypertension.
Mannitol is used for cerebral edema, drawing excess fluid out of the brain, and increasing urinary output of water and electrolytes.

Loop Diuretics

Mechanism of Action: Act on the renal loop of Henle to prevent sodium and chloride reabsorption.
Therapeutic Effects:
- Cause increased excretion of sodium chloride (NaCl) and some potassium (K+) loss.
- Can lead to hypokalemic metabolic alkalosis.
Uses:
- Treat severe hypertension and acute edema, particularly Furosemide, the drug of choice for acute edema management.
- Oliguria/Anuria cases may benefit from loop diuretics to stimulate urine production and fluid balance.

Additional Clinical Considerations

Metabolic disorders, such as metabolic acidosis, can occur due to prolonged use of specific diuretics.
Catamenial seizures, occurring during menstruation, may be exacerbated by increased cerebrospinal bicarbonate levels, contributing to epileptogenic impulses.

Conclusion

Proper understanding of diuretics, their classifications, mechanisms, and clinical applications is crucial in managing conditions like hypertension and fluid overload. Recognizing contraindications and potential side effects will optimize therapeutic outcomes.

Description

Explore the essential concepts of antihypertensive agents, particularly diuretics, as outlined in Chapter 1.1.3 of PHARM 315. This quiz covers metabolic alkalosis and mechanisms of action of carbonic anhydrase inhibitors and osmotic diuretics. Test your understanding and grasp the key details of this important pharmacological topic.