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Questions and Answers
What is the treatment for patients with increased intracranial pressure?
What is the treatment for patients with increased intracranial pressure?
What is a common adverse effect of spironolactone?
What is a common adverse effect of spironolactone?
Why should potassium-sparing diuretics be used with caution with other medications?
Why should potassium-sparing diuretics be used with caution with other medications?
What is the mechanism of action of Carbonic anhydrase inhibitors?
What is the mechanism of action of Carbonic anhydrase inhibitors?
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What is a complication of using osmotic diuretics?
What is a complication of using osmotic diuretics?
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What is the benefit of maintaining urine flow following acute toxic ingestion of substances capable of producing acute renal failure?
What is the benefit of maintaining urine flow following acute toxic ingestion of substances capable of producing acute renal failure?
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What is the primary mechanism of action of thiazides?
What is the primary mechanism of action of thiazides?
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What is a common adverse effect of thiazide diuretics?
What is a common adverse effect of thiazide diuretics?
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What is the therapeutic use of loop diuretics?
What is the therapeutic use of loop diuretics?
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What is the mechanism of action of spironolactone?
What is the mechanism of action of spironolactone?
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What is a potential adverse effect of loop diuretics?
What is a potential adverse effect of loop diuretics?
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What is the mechanism of action of triamterene and amiloride?
What is the mechanism of action of triamterene and amiloride?
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Study Notes
Thiazides (Low Ceiling Diuretics)
- Impair Na+ and Cl- reabsorption in the early distal tubule, increasing Ca reabsorption and K+ excretion.
- Increase urinary excretion of Na+ (5%), Cl-, K+, and water, leading to reduced ECF volume, cardiac output, and blood pressure.
- Therapeutic uses: Treatment of Hypertension, Mild Edema, and Calcium Nephrolithiasis.
- Adverse effects: Hypokalemia, Hypokalemic metabolic alkalosis, Hyperuricemia, Hyperglycemia, and Hyperlipidemia.
Loop Diuretics (Furosemide, Bumetanide, Torsemide, Ethacrynic acid)
- Inhibit the apical Na+-K+-2Cl- cotransporter of the thick ascending limb of the loop of Henle.
- Therapeutic effects: Treatment of Severe Edema, Pulmonary Edema, Acute Renal Failure, and Hypercalcemia.
- Adverse effects: Profound ECFV Depletion, Hypokalemia, Metabolic Alkalosis, Hypomagnesemia, Hypocalcemia, and Ototoxicity.
Potassium-Sparing Diuretics
- Mechanism of action:
- Spironolactone: antagonizes aldosterone at intracellular cytoplasmic receptor sites, preventing Na+ reabsorption and K+ and H+ secretion.
- Triamterene and amiloride: block Na+ transport channels, decreasing Na+/K+ exchange.
- Therapeutic uses: Induction of Diuresis, treatment of Secondary Hyperaldosteronism, Heart Failure, Resistant Hypertension, Ascites, and Polycystic Ovary Syndrome.
- Adverse effects: Gastric upset, Gynecomastia, Menstrual irregularities, Hyperkalemia, Nausea, Lethargy, and Mental confusion.
Osmotic Diuretics
- Mechanism of action: Hydrophilic chemical substances that are filtered through the glomerulus, then undergo little or no reabsorption, resulting in a higher osmolarity of the tubular fluid and osmotic diuresis.
- Therapeutic uses: Treatment of patients with increased intracranial pressure or Acute Renal Failure due to shock, drug toxicities, and trauma.
- Adverse effects: Extracellular water expansion and dehydration, Hyponatremia, and Hypernatremia until diuresis occurs.
Carbonic Anhydrase Inhibitors (Acetazolamide)
- Mechanism of action: Inhibits carbonic anhydrase in the proximal tubular epithelium, decreasing the ability to exchange Na+ for H+ and resulting in a mild diuresis.
- Therapeutic effects: Increased urinary pH and phosphate excretion by an unknown mechanism.
- Adverse effects: Hyperchloremic metabolic acidosis and decreased diuretic efficacy following several days of therapy.
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Description
Learn about the mechanism of action of thiazide diuretics, their pharmacological actions, therapeutic uses, and adverse effects. Understand how they affect sodium, potassium, and calcium levels in the body.
