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10 Diuretics
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Published
07/30/2024
DIURETICS OVERVIEWIn the {{c1::proximal convoluted tubule::tubular segment}}, {{c2::100::}}% of glucose and amino acids, {{c2::90}}% of Bicarbonate, {…
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DIURETICS OVERVIEWThe {{c1:: descending limb of the loop of henle::tubular segment}} is {{c2::less::more/less}} permeable to H20 and {{c2::impermeable…
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DIURETICS OVERVIEWNa-K-2Cl pump is present in the {{c1::ascending limb of the loop of henle.::tubular segment}}
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DIURETICS OVERVIEWThe ascending limb of the loop of henle is {{c1::permeable::permeable/impermeable}} to Na and {{c1::impermeable}} to H20.
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DIURETICS OVERVIEWThe distal convoluted tubule is {{c1::impermeable::permeable/impermeable}} to H20.
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DIURETICS OVERVIEWPrinicipal and intercalated cells are present in the {{c1::collecting tubule::tubular segment}}.
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DIURETICS OVERVIEWPrincipal cells are regulated by {{c1::aldosterone and ADH.::what 2 hormones?}}
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DIURETICS OVERVIEWIntercalated cells is regulated by {{c1::aldosterone::what hormone?}} and it secretes {{c2::H ions::what ions?}} and reabsorbs {{c2:…
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DIURETICS General indications:{{c1::Hypertension}}{{c1::Chronic Heart Failure}}{{c1::Renal failure}}{{c1::Edematous states}}
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Carbonic Anhydrase Inhibitors Representative Drugs: {{c1::Brinzolamide, Acetazolamide, Dorzolamide, Methazolamide}}
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CAIs are {{c1::weak::weak/strong}} diuretics
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DIURETICSSubclass: Carbonic Anhydrase InhibitorsBicarbonate Reabsorption StepsEvents 1Sodium enters the cell via {{c…
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Carbonic Anhydrase Inhibitors Effects:{{c1::↓ Bicarbonate → ↑ Urine pH and ↓ Body pH (Metabolic acidosis)↓ Aqueous Humor↓ CSF and CSF pH → Drowsiness↓…
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DIURETICSSubclass: Carbonic Anhydrase InhibitorsNumber one clinical indication for CAI: {{c1::Glaucoma}}
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Carbonic Anhydrase Inhibitors Clinical Uses:{{c1::GlaucomaUrinary alkalinizationMetabolic alkalosis due to excessive diureticsAcute Mountain Sick…
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DIURETICSSubclass: Carbonic Anhydrase InhibitorsToxicity:Hypersensitivity reaction is due to its {{c1::sulfonamide}} derivative.
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DIURETICSSubclass: Carbonic Anhydrase InhibitorsUses:{{c1::Topical::What}} form is preferred in the management of glaucoma.
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Loop Diuretic Representative Drugs: {{c1::Furosemide, Bumetanide, Torsemide, Ethacrynic acid}}
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Loop Diuretics MOA: {{c1::Inhibits cotransport of Na, K, and Cl (NKCC2 transporter)}}
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Loop Diuretics Clinical Uses: {{c1::Acute pulmonary edema and other edematous conditions (CHF) Acute HYPERcalcemiaHYPERkalemiaAcute Kidney I…
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{{c1::Loop Diuretics}} have the greatest Diuretic Effect
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Loop Diuretics Effects:Hypovolemia{{c1::Reversible Ototoxicity (irreversible if chronic)HypomagnesemiaHypokalemia → Hypokalemic Metabolic AlkalosisHyp…
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K Sparing Diuretic Mineralocorticoid Antagonists (MRAs) Representative Drugs: {{c1::Spironolactone, Eplerenone}}
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K Sparing Diuretic Epithelial Na+ Channel (ENaC) Inhibitors Representative Drugs: {{c1::Amiloride, Triamterene}}
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MOA of K+ Sparing Diuretics: {{c1::ENaC Inhibition and Aldosterone Antagonism}}
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K+ Sparing Diuretic General ADE: {{c1::HyperkalemiaKidney stonesHypochloremic metabolic acidosisAcute Renal Failure}}
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Mineralocorticoid Receptor Antagonist ADE: {{c1::Menstrual irregularities and gynecomastia}}
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[QC] Gynecomastia, Menstrual Irregularities1. Spironolactone2. Epleronone{{c1::A}}
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Osmotic Diuretics Representative Drugs: {{c1::Glycerine, Urea, Mannitol, Isosorbide}}
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T/F: Osmotic diuretics are used in patients with ARF with low GFR and acute tubular necrosis by increasing urine volume.{{c1::T}}
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Effect of Osmotic Diuretics on Na levels:{{c1::Hyponatremia (initially), then hypernatremia (long-term use)}}
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All loop diuretics are sulfonamides EXCEPT {{c1::ETHACRYNIC ACID}}
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Osmotic Diuretics Clinical Uses: {{c1::Decrease intracranial pressure (ICP)Urinary excretion of toxic substances}}
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Toxic effect of Osmotic Diuretics before diuresis:{{c1::Extracellular volume expansion}}
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Prototype osmotic agent/diuretic:{{c1::Mannitol}}
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Other positive effect of epleronone: {{c1::Slowing of diabetic albuminuria}}
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Mineralocorticoid Receptor Antagonist Clinical Uses: {{c1::Mineralocorticoid Excess or Hyperaldosteronism}}
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ENaC Inhibitor Clinical Uses: {{c1::Combination with diuretics that cause hypokalemia (Furosemide)}}
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Thiazide Diuretic Representative Drugs:{{c1::Chlorothiazide IndapamideHydrochlorothiazide Chlorthalidone Metolazone}}
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Thiazides Diuretics Effects:{{c1::Hypokalemic Metabolic alkalosisHyperuricemiaHypercalcemiaHyperglycemia (Imparied Glucose tolerance)HyperlipidemiaHyp…
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{{c1::Chlorothiazide}} is the only available thiazide diuretic for parenteral route
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[QC] Potency1. Chlorthiazide2. Hydrochlorothiazide{{c1::B}}
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{{c1::Chlorthalidone}} is a slowly absorbed Thiazide diuretic w/ longer duration of action, has significant CAI activity
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{{c1::Indapamide, Chlorthalidone}} is/are thiazide diuretics excreted in the {{c2::biliary system}}
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{{c1::Metolazone}} is a thiazide drug more potent compared to Chlorothiazide and can be used for patients with severe GFR (low GFR)
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{{c1::Triamterene}} is a K+ Sparing Diuretic that have the highest propensity to cause {{c2::kidney stones}} as well as {{c2::acute renal failure}} wh…
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DIURETICS CLASSIFICATIONSITE OF ACTION {{c1::Carbonic annhydrase inhibitors}}{{c2::Proximal Convoluted Tubul…
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Thiazides MOA: {{c1::Inhibits NaCl transport (NCC transporter)}}
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Thiazides Clinical Uses:{{c1::HypertensionHeart FailureNephrolithiasis due to Idiopathic HypercalciuriaNephrogenic Diabetes Insipidus::4}}
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