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Urinary Drugs 411

Urinary

QuestionAnswer
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
Created by: lbreimeir
 

 



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