S2W5 Diuretics (PD)

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What are diuretics?
A class of drugs that increase diuresis or the production of urine. Also increase urine production by increasing excretion of sodium (naturesis)
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What are the four types of diuretics?
Loop diuretics, thiazid diuretics, thiazide-like diuretics, potassium-sparing diuretics.
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What are some examples of loop diuretics?
end in -mide
Furosemide, Bumetamide, torsemide
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What is the site and mode of action of loop diuretics?
Thick ascending limb of the LOH
They block the NKCC in the ascending limb and decrease Na and Cl reabsorption
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What are some clinical uses of loop diuretics?
Oedema due to heart failure, Hepatic disease, nephrotic syndrome, acute pulmonary oedema, acute and chronic renal failure
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What are some adverse effects of loop diuretics?
Hypokalaemia, Hyponatraemia, Dehydration, Hypomagnesaemia, impotence, hyperuricaemia, impaired glucose tolerance, hpocalcaemia, ototoxicity, acute urine retention
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What are some interaction of loop diuretics?
reduce lithium excretion - lithium toxicity
hypokalaemia - increase digoxin toxicity
ototoxic and nephrotoxic effects of aminoglycosides are potentiated by furosemide.
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What are some examples of thiazide diuretics?
End in -thiazide
Bendroflumethiazide, Hydrochlorothiazide
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What is the site and mode of action of thiazide diuretics?
Distal convoluted tubule (DCT) they block the NaCl transporter and inhibit sodium and chloride reabsorption
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What are some clinical uses of thiazide diuretics?
Hypertension, oedema due to heart failure, liver disease, nephrotic syndrome, nephrogenic diabetes insipidus
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What are some side effects of thiazide diuretics?
Hypokalaemia, hyponatraemia, dehydration, impotence, impaired glucose tolerance, hyperuricaemia, hypercalcaemia (rare: bone marrow supression and pancreatitis)
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What are the two types of potassium sparing diuretics?
Aldosterone antagonists and sodium channel blockers
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What are some examples of aldosterone antagonists?
end in -one
Spinolactone, eplerenone
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What are soe examples of sodium channel blockers?
Amiloride and triameterene
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What is the site and mode of action of potassium sparing diuretics?
The collecting duct
Amiloride and triameterene block the epithelial sodium channel (ENaC) in the distal tubule
Spinolactone and eplerenone act through its active metabolite, canrenone, which blocks aldesterone receptors on the distal tubule
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What are some clinical uses of potassium sparing diuretics?
Heart failure, Nephrotic syndrome, cirrhosis, oedema (maily spironolactone), conn's syndrome
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What are some side effects of potassium sparing diuretics?
Nausea and vomiiting, hyperkalaemia, gynaecomastia (spironolactone), menstrual disturbances, impotence, testicular atrophy
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What are some interactions of potassium sparing diuretics?
taken with NSAIDs or ACE inhibitor can increase risk of hyperkalaemia
Spironolactone decreases digoxin excretion - increase risk of digoxin toxicity
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What is short term diuretic tolerance?
Decrease in reponse to the diuretic after the first dose
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What is long term diuretic tolerance?
occurs after loong term administration of a diuretic causes hypertrophy of dital nephron segments with an increase of sodium reabsorption especially with loop diuretics.
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Other cards in this set

Card 2

Front

What are the four types of diuretics?

Back

Loop diuretics, thiazid diuretics, thiazide-like diuretics, potassium-sparing diuretics.

Card 3

Front

What are some examples of loop diuretics?

Back

Preview of the front of card 3

Card 4

Front

What is the site and mode of action of loop diuretics?

Back

Preview of the front of card 4

Card 5

Front

What are some clinical uses of loop diuretics?

Back

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