32 Questions
What is the effect of diuretics on urinary flow rates?
Increase urinary flow rates
Which type of diuretic is associated with potassium sparing?
Kalium-sparing
What is the effect of mannitol on urine production?
Increase urine production
Which of the following is an antagonist of ADH?
Lithium
What is the effect of Furosemide on sodium reabsorption?
Decrease sodium reabsorption
Which of the following is a type of diuretic that works by inhibiting carbonic anhydrase?
Carbonic anhydrase inhibitor
Which of the following conditions is associated with acute edema?
Congestive heart failure
What is the mechanism of action of carbonic anhydrase inhibitors?
Inhibit CA and Na+/HCO3- reabsorption
Which of the following is a clinical use of acetazolamide?
Treatment of glaucoma
What is a side effect of carbonic anhydrase inhibitors?
Hyperchloremic metabolic acidosis
What is the effect of osmotic diuretics on water excretion?
Increase water excretion
Which of the following is a loop diuretic?
Furosemide
What is the mechanism of action of loop diuretics?
Inhibit Na+/K+/2Cl- cotransport
What is a clinical use of loop diuretics?
Treatment of acute renal failure
What is a side effect of loop diuretics?
Hypokalemic metabolic alkalosis
Which of the following is an adverse reaction of osmotic diuretics?
Dehydration
Which of the following diuretics is known to inhibit NaCl reabsorption from the luminal DCT?
Thiazide
What is the primary adverse effect of thiazide diuretics?
All of the above
Which of the following diuretics is an aldosterone antagonist?
Spironolactone
What is the primary mechanism of action of potassium-sparing diuretics?
Inhibition of aldosterone
Which of the following diuretics is known to cause carbohydrate intolerance?
Thiazide
What is the primary clinical use of thiazide diuretics?
All of the above
Which of the following diuretics is known to cause allergic reactions?
Demeclocycline
What is the primary mechanism of action of demeclocycline?
Inhibition of ADH
Which of the following diuretics is known to cause hyperlipidemia?
Thiazide
What is the primary clinical use of spironolactone?
All of the above
What is the likely consequence of decreased cardiac output on the kidney?
Decreased glomerular filtration rate
Which of the following is NOT a potential adverse reaction to a certain medication?
Hypokalemia
What is the effect of xanthines on the kidney?
Increased glomerular filtration rate
What is the likely consequence of decreased renal blood flow on the kidney?
Acute renal failure
What is the effect of decreased cardiac output on sodium levels?
Increased sodium reabsorption
What is the likely consequence of hyperkalemia on the kidney?
Acute renal failure
Study Notes
Diuretics
- Diuretics increase urinary flow rates, causing Na3CI reabsorption and water loss.
Mechanism of Action
- Diuretics work by inhibiting Na+ reabsorption in the kidneys, increasing urinary flow rates and water loss.
Types of Diuretics
-
Carbonic Anhydrase Inhibitors
- Inhibit carbonic anhydrase enzyme in the proximal tubule.
- Inhibit NaHCO3 reabsorption, leading to ↓ HCO3.
- Clinical uses:
- Glaucoma (↓ aqueous humor formation, ↓ intraocular pressure).
- Urine alkalinization (weak acid drugs excretion).
- Metabolic Alkalosis (Nk3, intravascular volume ↑, ↑ mineralcorticoid).
- Acute mountain sickness (VCSF ↓, pHCSF).
- Adverse reactions:
- Hypercholeremic metabolic acidosis.
- Osmotic diuresis.
- Renal stones.
- Ca2+ excretion.
- Phosphaturia.
- Hypercalciuria.
-
Osmotic Diuretics
- Increase water excretion.
- Inhibit water reabsorption in the proximal tubule.
- Examples:
- Mannitol.
- Clinical uses:
- Acute pulmonary edema.
- Acute renal failure.
- Elevated intracranial pressure.
- Osmotic diarrhea.
- Adverse reactions:
- Dehydration.
- Hyponatremia.
-
Loop Diuretics
- Inhibit Na+ and K+ reabsorption in the Loop of Henle.
- Examples:
- Furosemide.
- Bumetanide.
- Torsemide.
- Ethacrynic acid.
- Clinical uses:
- Hyperkalemia.
- Hypercalcamia.
- Acute pulmonary edema.
- Mild hypertension.
- Acute renal failure.
- Anion poisoning treatment.
- Adverse reactions:
- Dehydration.
- Hyponatremia.
- Hypokalemia.
- Metabolic alkalosis.
- Allergic reaction.
- Ototoxicity.
- Hypomagnesemia.
- Hyperuricacemia.
-
Thiazide Diuretics
- Inhibit NaCl reabsorption in the Distal Convoluted Tubule.
- Examples:
- Chlorothiazide.
- Chlortalidone.
- Clinical uses:
- Mild heart failure.
- Hypertension.
- Nephrogenic diabetes insipidus.
- Prevent recurrent stone formation.
- Adverse reactions:
- Hypokalemic metabolic alkalosis.
- Hyperuricaemia.
- Hyponatremia.
- Fatigue.
- Allergic reaction.
- Carbohydrate intolerance.
- Hyperglycemia.
- Hyperlipidemia.
-
Potassium-Sparing Diuretics
- Inhibit aldosterone's effects in the Collecting Duct.
- Examples:
- Spironolactone (Aldactone).
- Triamterene (Dyrenium).
- Amiloride (Midamor).
- Clinical uses:
- Heart failure.
- Hyperaldosteronism.
- Hepatic cirrhosis.
- Nephrogenic diabetes insipidus.
- Syndrome of Inappropriate ADH (SIADH).
- Adverse reactions:
- Hyperkalemia.
- Headache.
- Nausea.
- Cardiac toxicity.
- Renal failure.
Other Diuretics
-
Xanthines
- Examples:
- Caffeine.
- Theophylline.
- Mechanism:
- Increase cardiac output and RBF.
- Increase GFR.
- ↓ Na+, Cl- and water loss.
- Examples:
This quiz covers the mechanism of action of diuretics, including their effects on urinary flow rates, sodium chloride reabsorption, and blood pressure.
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