Katzung Pharm
Terms
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- Diuretic group that acts predominantly in the proximal tubule
- Carbonic Anhydrase inhibitors
- MOA Carbonic Anhydrase inhibitors
- Block NaHCO3 reabsorption
- site of loop diuretic action
- Thick ascending limb (Loop of Henle)
- Inhibition of salt transport by loop diuretics may cause loss of...
- Divalent cations (Mg2+ and Ca2+)
- Contraindications of carbonic anhydrase inhibitors
- Patients with Cirrhosis
- Reduction in the secretion of loop diuretics may be a result of...
- Administration of NSAIDS or Probenecid, which compete for weak acid secretion in the proximal tubule.
- MOA of loop diuretics
- Inhibit the luminal Na+/K+/2Cl- transporter
- Loop diuretics induce renal prostaglandin synthesis
- NSAIDS (indomethacin) can interfere with the actions of the loop diuretics (especially in those with Nephrotic syndrome or hepatic cirrhosis)
- Vascular effects of Furosemide and Ehacrynic acid
- Reduce pulmonary congestion and left ventricular filling pressures in heart failure (Furosemide increases renal blood flow)
- Indications for loop diuretics
- acute pulmonary edema, acute hypercalcemia,hyperkalemia, acute renal failure and anion disease
- Toxicity of loop diuretics
- Hypokalemic metabolic acidosis, ototoxicity (usually reversible), hyperuricemia, hypomagnesemia, Allergic reactions, SEVERE dehydration.
- Site of action for Thiazide diuretics
- Distal convoluted tubule
- Only parenteral thiazide
- Chlorothiazide
- MOA of Thiazide diuretics
- Blocking the Na+/Cl- transporter
- In contrast to loop diuretics, thiazides actually enhance....
- Ca2+ reabsorption in the Distal convoluted tubule
- Major indications for thiazide diuretics
- Hypertension, heart failure, nephrolithiasis due to idiopathic hypercalciuria, nephrogenic diabetes insipidius
- Toxicity of Thiazides
- Hypokalemic metabolic acidosis, Impaired carbohydrate tolerance, Hyperlipidemia, hyponatremia, allergic rxn
- Excessive use of any diuretic is dangerous in...
- hepatic cirrhosis, borderline renal failure, or heart failure
- Triamterene and amiloride do not block the aldosterone recpetor, but
- directly interfere with Na+ entry through the ion channels in the apical membrane
- Toxicity of potassium sparing diuretics
- Hyperkalemia, Hyperchloremic metabolic acidosis, Gynecomastia, (BPH with spironolactone)
- Diuretic induced renal failure
- Triamterene with indomethacin has induced ARF
- Treatment of nephrolithiasis
- Thiazide diuretic