Renal Pharm
Terms
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Name 4 osmotic diuretics
action -
mannitol
glycerine
isosorbide
glycerin
PCT -
Osmotic diuretics use (3)
SE (2) -
shock
drug overdose
decrease CSF/intraocular pressure
(i.e. narrow or closed angle glaucoma)
Pulmonary edema
dehydration
(dont use with CHF bc it causes an initial plasma volume expansion) -
Acetazolamide and Dorzolamide MOA
action and MOA -
carbonic anhydrase inhibitor
PCT thus causing sodium and bicarbonate excretion - Acetazolamide use (3)
-
glaucoma
urinary alkalinization
metabolic alkalosis - Acetazolamide SE
-
hypercholermemic acidosis
neuropathy
ammonia toxicity
sulfa allergy -
Thiazide diuretics MOA
action
(hydrochlorothiazide, benzthiazide, indapide, metolazone) -
inhibit NaCl reabsorption
(thus increasing excretion of Na, Cl, K, H and decreasing excretion of calcium)
early distal tubule - How do thiazide diuretics cause hypokalemic alkalosis?
- sodium load in tubule causes increased Na/K antiport leading to K loss as well as H
- Thiazide diuretics use (4)
-
HTN
CHF
idiopathic hypercalcuria
nephrogenic diabetes insipidus -
SE of thiazide diuretics (4)
(dont forget mnemonic) -
HyperGLUC
glycemia
lipidemia
uricemia
calcemia - Name 4 loop diuretics
-
ethacrynic acid
furosemide
bumetanide
torsemide
(most effective diuretics) -
loop diuretic MOA
action -
block Na/K/2Cl transporter thus preventing hypertonic medulla (i.e. prevents concentration of urine)
thick ascending limb -
What is different about ethcyrnic acid compared to the other loop diuretics
(important) - it is not a sulfonamide thus it can be used when a pt has a sulfa allergy
- Loop diuretics use (3)
-
edematous states (CHF, cirrhosis, nephrotic syndrome)
HTN
hypercalcemia -
Loop diuretics SE (6)
(mnemonic) -
OH DANG
ototoxicity
hypokalemia
dehydration
sulfa allergy
nephritis (interstitial)
gout - Contraindications of loop diuretics (3)
-
oral hypoglycemics
Lithium (decreases clearance)
aminoglycosides (additive ototoxicity/nephrotoxicity) -
Name 3 potassium sparing diuretics
(mnemonic) -
K+ STAys
spironolactone
triamterene
amiloride -
K sparing MOA (2 different one
action -
spironolactone: compettive aldosterone inhibitor
amiloride and triamterene:
block Na channels
collecting tubule -
K sparring agents use (3)
SE (2) -
hyperaldosteronism (Conns)
K depletion
CHF
hyperkalemia
gynecomastia (via an antiandrogen effect) -
Name an agent used for SIADH
MOA -
demeclocycline
ADH antagonist - What is a side effect of both lithium and alcohol
- decreased ADH
-
Agents that cause SIADH (6)
may not be as imp -
carbamezepine
thiazides
certain TCA
phenothiazines
chlorpropamide
cisplatin