b
Which acts on the Proximal Convoluted Tubule?
a) Loop diuretics
b) Carbonic Anhydrase inhbitors
c) Thiazides
d) Vaptans
e) K+ Sparing Diuretics
a
Which acts on the Thick Ascending Limb(Loop of Henle)?
a) Loop diuretics
b) Carbonic Anhydrase inhbitors
c) Thiazides
d) Vaptans
e) K+ Sparing Diuretics
c
Which acts on the Distal Convoluted Tubule?
a) Loop diuretics
b) Carbonic Anhydrase inhbitors
c) Thiazides
d) Vaptans
e) K+ Sparing Diuretics
d,e
Which acts on the collecting ducts?
a) Loop diuretics
b) Carbonic Anhydrase inhbitors
c) Thiazides
d) Vaptans
e) K+ Sparing Diuretics
acetazolamide
What is the Diuretic Carbonic Anhydrase inhibitors?
dorzolamide, brinzolamide
What are the Ophthalmic Carbonic Anhydrase inhibitors? (2)
increase the excretion of sodium bicarbonate; which also increases the excretion of sodium and water
CA inhibitor MOA?
base; metabolic acidosis
Sodium bicarbonate is a _______; therefore removing it from the kidneys
will result in __________.
b
Which is mostly used for Open-angle Glaucoma?
a) Loop diuretics
b) Carbonic Anhydrase inhbitors
c) Thiazides
d) Vaptans
e) K+ Sparing Diuretics
metabolic alkalosis, mountain sickness, seizures
What metabolic conditions can we use CA inhibitors for? (3)
b
Which are contraindicated in patients with hepatic impairment?
a) Loop diuretics
b) Carbonic Anhydrase inhbitors
c) Thiazides
d) Vaptans
e) K+ Sparing Diuretics
inhibit Na/K/2Cl symporter in thick ascending limb of loop of Henle; causes solutes + water to remain in filtrate and become excreted in the urine
Loop diuretic MOA?
Na, K, Mg, Ca
Which ions are lost in Loop diuretics? (4)
furosemide, bumetanide, ethacrynic acid, torsemide
What are the loop diuretics? (4)
a
Which are the most effective?
a) Loop diuretics
b) Carbonic Anhydrase inhbitors
c) Thiazides
d) Vaptans
e) K+ Sparing Diuretics
NSAIDs, probenecid; compete for tubular secretion
What can decrease the efficacy of loop diuretics? Why?
HCTZ, chlorthalidone, indapamide, metolazone, chlorothiazide
What are the Thiazides? (5)
inhibit Na+ reabsorption in DCT by blocking sodium-chloride channel
Thiazide MOA?
Na, K, Mg, H+ protons
Which ions are lost in thiazides? (4)
Ca2+; blocking na reabsorption on the luminal side increases calcium reabsorption on interstitial membrane
Which ion is gained in thiazides? Why?
prevent K+ excretion at collecting tubules; prevent hypokalemia
What is the function of K+ sparing diuretics?
spironolactone, eplerenone
What are the aldosterone antagonists? (2)
amiloride, triamterene
What are Na+ influx inhibitors? (2)
a
Which has a longer half-life?
a) amiloride
b) triamterene
b
Which is more toxic?
a) amiloride
b) triamterene
b
Which causes off-target andronergic effects?
a) Eplerenone
b) Spironolactone
a
Which is CYP3A4 substrate?
a) Eplerenone
b) Spironolactone
acidosis; H+
K+ sparing diuretics can cause metabolic ______ because of their
interference with intercalated cells secretion of _______ ions.
CA inhibitors, K+ sparing
Which diuretics cause acidosis? (2)
prevent ADH-mediated free water retention by antagonizing V2 receptors & correct hyponatremia
Vaptans MOA?
a,c
Where are V1a receptors located?
a) CNS
b) kidney
c) vasculature
d) liver
b
Where are V2 receptors found?
a) CNS
b) kidney
c) vasculature
d) liver
a
Acts on V1a & V2 receptors.
a) conivaptan
b) tolvaptan
b
Which is V2 selective?
a) conivaptan
b) tolvaptan
IV; diarrhea
Osmotic diuretics must be given ______ due to their risk of causing _________.
limits osmosis of water into interstitial space; pulls water from intracellular space; causes fluid excretion
Osmotic diuretics MOA?
mannitol
What is the osmotic diuretic?
intraocular; intracranial
Mannitol can reduce _______ & _______ pressure.