Pharmacology of Diuretics
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Questions and Answers

What is a primary therapeutic indication for potassium-sparing diuretics like Spironolactone and Eplerenone?

  • Prevention of kidney stones
  • Treatment of sodium retention
  • Increased hydrogen ion excretion
  • Management of conditions with aldosterone excess (correct)
  • Which diuretic is most specifically associated with the risk of gynecomastia?

  • Furosemide
  • Amiloride
  • Spironolactone (correct)
  • Eplerenone
  • What is a significant adverse effect of osmotic diuretics like Mannitol?

  • ECF volume expansion (correct)
  • Metabolic alkalosis
  • Hyperkalemia
  • Hypokalemia
  • What do thiazide diuretics primarily do in relation to sodium and water excretion?

    <p>Promote greater net sodium loss compared to water</p> Signup and view all the answers

    Which of the following drugs is a loop diuretic?

    <p>Furosemide</p> Signup and view all the answers

    What is a common metabolic consequence of potassium-sparing diuretics?

    <p>Metabolic acidosis</p> Signup and view all the answers

    In the management of acute renal failure, osmotic diuretics serve primarily to:

    <p>Enhance renal toxin excretion</p> Signup and view all the answers

    Which adverse effect is particularly concerning in patients taking potassium-sparing diuretics and also on renin-angiotensin system inhibitors?

    <p>Hyperkalemia</p> Signup and view all the answers

    What is the primary mechanism of action of loop diuretics in the nephron?

    <p>Inhibit sodium, potassium, and chloride reabsorption in the ascending limb</p> Signup and view all the answers

    Which of the following is NOT an indication for the use of carbonic anhydrase inhibitors?

    <p>Hypertension</p> Signup and view all the answers

    Which adverse effect is most commonly associated with the use of loop diuretics?

    <p>Hypokalemia</p> Signup and view all the answers

    What is a unique characteristic of potassium-sparing diuretics compared to other diuretics?

    <p>They reduce potassium excretion in urine.</p> Signup and view all the answers

    Which loop diuretic is recognised as the prototype with the most potent effects?

    <p>Furosemide</p> Signup and view all the answers

    Which diuretic class can lead to metabolic acidosis due to its mechanism of action?

    <p>Carbonic anhydrase inhibitors</p> Signup and view all the answers

    What potential interaction should be monitored when a patient is on loop diuretics?

    <p>NSAIDs may reduce the effectiveness of loop diuretics.</p> Signup and view all the answers

    What is a common adverse effect associated with thiazide diuretics?

    <p>Hyponatremia</p> Signup and view all the answers

    What is the primary adverse effect associated with carbonic anhydrase inhibitors?

    <p>Drowsiness and paresthesia</p> Signup and view all the answers

    Which diuretic class is characterized by causing significant sodium and water excretion, affecting both urine output and blood pressure?

    <p>Loop diuretics</p> Signup and view all the answers

    What is a primary characteristic of loop diuretics in the management of acute pulmonary edema?

    <p>They provide rapid onset of diuresis with a short duration of action.</p> Signup and view all the answers

    Which class of diuretics is most likely to cause significant hypokalemia leading to digoxin toxicity?

    <p>Loop diuretics</p> Signup and view all the answers

    What common adverse effect is associated with thiazide diuretics?

    <p>Hyperglycemia, particularly in diabetics</p> Signup and view all the answers

    Which diuretic class is unnecessary for patients with severely reduced renal function?

    <p>Thiazide diuretics</p> Signup and view all the answers

    What effect does thiazide diuretics have on calcium levels in the body?

    <p>Increases calcium retention</p> Signup and view all the answers

    Which adverse effect is specifically associated with the use of ethacrynic acid?

    <p>Ototoxicity leading to permanent deafness</p> Signup and view all the answers

    What is the primary mechanism of action for potassium-sparing diuretics?

    <p>Antagonism of aldosterone effects in the distal nephron</p> Signup and view all the answers

    Which of the following interactions can diminish the effectiveness of thiazide diuretics?

    <p>Use of NSAIDs that inhibit prostaglandin synthesis</p> Signup and view all the answers

    In which scenario would the addition of thiazide diuretics be beneficial?

    <p>In patients experiencing resistance to loop diuretics</p> Signup and view all the answers

    Which condition can hyperuricemia from diuretic use potentially trigger?

    <p>Gout attacks</p> Signup and view all the answers

    What serious adverse effect can occur due to chronic diuretic use?

    <p>Circulatory collapse from fluid imbalance</p> Signup and view all the answers

    Which diuretic is suggested as the primary choice for patients with nephrotic syndrome?

    <p>Loop diuretics</p> Signup and view all the answers

    What effect do thiazide diuretics have on lipid profiles?

    <p>Can elevate LDL and triglycerides</p> Signup and view all the answers

    Study Notes

    Diuretics

    • Diuretics inhibit the reabsorption of solute in the nephron, which leads to water remaining in the tubule and being excreted.
    • Most diuretics act by inhibiting the reabsorption of sodium, potassium, and chloride, but vary in their site of action along the nephron.

    Carbonic Anhydrase Inhibitors

    • Carbonic anhydrase inhibitors primarily act in the proximal convoluted tubule (PCT) and block the carbonic anhydrase enzyme.
    • These inhibitors prevent the reabsorption of bicarbonate and sodium, leading to a rise in the concentration of these ions in the tubular fluid.
    • Bicarbonate loss leads to metabolic acidosis.
    • These are not very potent diuretics and their effects wane after several days.
    • They have a wide range of uses, including treatment of glaucoma, altitude sickness, and seizures.

    Loop Diuretics

    • Loop diuretics are the most potent diuretics and act in the ascending limb of the loop of Henle, where they inhibit the Na+/K+/2Cl- cotransporter.
    • They can cause an increase in urine output of up to 20% of the filtered load.
    • They also inhibit reabsorption of calcium and magnesium, resulting in their increased excretion in the urine.
    • Often used to treat edema associated with heart failure, hypertension, and nephrotic syndrome.

    Thiazides

    • These diuretics act in the distal convoluted tubule (DCT) where they inhibit the sodium chloride exchanger.
    • They are widely used to treat hypertension and edema.
    • They often augment their effects on blood pressure through the inhibition of peripheral vascular resistance.
    • Often used for their antihypertensive action as they can decrease systemic vascular resistance.

    Thiazide-Like Diuretics

    • These drugs are similar to thiazides in their mechanism of action but may be used in situations where thiazide diuretics may not be effective, such as impaired renal function.
    • The most common example is metolazone.

    Potassium-Sparing Diuretics

    • These diuretics act in the distal nephron and have a unique mechanism of action compared to other diuretics, which is to antagonize the effects of aldosterone.
    • Two classes : 1. Aldosterone receptor antagonists (e.g., spironolactone) 2. Sodium channel blockers (e.g., amiloride, triamterene).
    • They reduce sodium reabsorption and increase potassium reabsorption.
    • They are often used to offset the potassium loss caused by other diuretics.

    Osmotic Diuretics

    • These diuretics are nonabsorbable and act in all water-permeable segments of the nephron, including the PCT and descending limb of the loop of Henle.
    • They are hypertonic solutions that must be given intravenously.
    • Their primary use is to reduce intracranial pressure, or prevent acute renal failure due to nephrotoxic agents.

    ADH Antagonists

    • These drugs selectively inhibit the action of ADH, leading to increased water excretion without affecting sodium excretion.
    • They can be used in cases of hyponatremia to increase plasma sodium levels.

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    Related Documents

    Diuretics F23.2 PDF

    Description

    Test your knowledge on diuretics, including their mechanisms of action and various classes such as carbonic anhydrase inhibitors and loop diuretics. Explore how these medications impact the nephron and their clinical applications. This quiz covers essential pharmacological concepts related to diuretic drugs.

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