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Urinary Drugs 411
Urinary
Question | Answer |
---|---|
60-70% salt/water reabsorbed | Proximal tubule |
Very low Na permeability | Descending loop of Henle |
High Na permeability, 20-25% Na reabsorbed | Ascending loop of Henle |
5-10% Na reabsorbed, depends on aldosterone | Distal Convoluted Tubule |
Water reabsorbed if ADH present | Collecting Duct |
Prevents reabsorption of bicarbonate. Increases osmotic pressure. Cause osmotic diuresis. | Acetazolamide |
Used primarily to produce alkaline urine | Acetazolamide |
Diuretic effects loss with chronic use | Acetazolamide |
Not as effective as diuretics that prevent Na reabsorption | Acetazolamide |
Inhibit Na reabsorption at distal convoluted tubule | Thiazide Diuretics |
Moderate potency, can only affect 10% of Na load | Thiazides |
Used short term for mild edema | Thiazides |
Loses diuretic effect after about 1-2 weeks, antihypertensive effect remains chronically | Thiazides |
Thiazide Diuretics Drugs | Chlorothiazide, HCTZ, Metolazone, Indapamide |
Arrhythmias, orthostatic hypotension, muscle weakness/cramps/pain | Consequences of Thiazide-induced hypokalemia |
Thiazides ADRs | hypokalemia, hyperuricemia, hyperglycemia, hypercholesterolemia |
Most effective agents, infinite dose response | Loop Diuretics |
For moderate to severe edema | Loop Diuretics |
Disease states where thiazides must be used w/ caution | severe renal impairment, DM, electrolyte imbalances, pregnant, elderly, gout |
Loop Diuretics Drugs | Bumetanide, Ethacrynic acid, Furosemide |
Loop Diuretics ADRs | Hypokalemia, hypomagnesemia, hyperuricemia, hypercholesterolemia, hypovolemia, ototoxicity |
Consequences of Thiazide-induced hypokalemia | Arrhythmias, orthostatic hypotension, muscle weakness/cramps/pain |
hypokalemia, hyperuricemia, hyperglycemia, hypercholesterolemia | Thiazides ADRs |
Hypokalemia, hypomagnesemia, hyperuricemia, hypercholesterolemia, hypovolemia, ototoxicity | Loop Diuretics ADRs |
K+ sparing diuretics drugs | Amiloride, Spironolactone, Triamterene |
Mild diuretics, usually used w/ other diuretics | K+ sparing diuretics |
K+ induced hyperkalemia risk groups | renal impairment, DM, elderly |
Signs and symptoms of hyperkalemia | Parasthesias, muscular weakness flaccid paralysis of extremeties, bradycardia, shock, ECG abnormalities |
Parasthesias, muscular weakness flaccid paralysis of extremeties, bradycardia, shock, ECG abnormalities | Signs and symptoms of hyperkalemia |
Consequences of Thiazide-induced hypokalemia | Arrhythmias, orthostatic hypotension, muscle weakness/cramps/pain |
Antagonizes the effects of aldosterone, diuretic activity only in presence of aldosterone | Spironolactone |
Used in combo w/ HCTZ to prevent HCTZ induced hypokalemia | Spironolactone |
Causes hirsutism, endocrine problems | Spironolactone |
Increase intravascular osmotic pressure. Keep water and Na in tubule | Osmotic Diuretics |
Acetazolamide | Proximal tubule diuretic |
Chlorothiazide | Thiazide Diuretic (distal conv. tubule) |
Hydrochlorothiazide (HCTZ) | Thiazide Diuretic (distal conv. tubule) |
Indapamide | Thiazide Diuretic (distal conv. tubule) |
Amiloride | K+ sparing diuretic |
Spironolactone | K+ sparing diuretic |
Triamterene | K+ sparing diuretic |
Bumetanide | Loop Diuretic |
Ethacrynic acid | Loop Diuretic |
Furosemide | Loop Diuretic |
Mannitol-IV | Osmotic Diuretic |
Urea-IV | Osmotic Diuretic |
Glycerin-PO | Osmotic Diuretic |