Zusammenfassung der Ressource
Diuretics
- Increases urination by decreasing reabsorption of ions like sodium
- Water is pulled by the ions via passive transport
- Used to treat edema, HTN, and glaucoma
- Thiazide Diuretics
- Most common of all diuretics
- Most common: HCTZ
- Others: metolazone; chlorthalidone; indapamide
- Affects the distal tubule
- Inhibits the Na/Cl co-transporter
- Increases excretion of Na, Cl, K, and Mg
- Less Ca excretion
- Reduced peripheral vascular resistance
- Used to treat HTN, diabetes insipidus, hypercalciuria, and heart failure
- Taken orally for 1-3 wks to decrease BP
- Secreted by the kidneys
- Side effects: hyperuremia (and gout), hyponatremia; hypokalemia; volume depletion; hyperglycemia; hyperlipidemia
- Osmotic Diuretics
- Carry water as they are filtered through the glomerulus
- Mannitol is the most common
- Increases water excretion, but not sodium excretion
- Prevents acute renal failure and increased intracranial pressure
- Potassium-Sparing Diuretics
- Acts on collecting tubule
- Inhibits Na reabsorption and K excretion
- Caution in renal disease patients: increased risk for hyperkalemia
- Used to treat HTN, but with a thiazide
- Aldosterone Antagonists
- Prevent proteins from stimulating Na/K exchange sites
- Blocking aldosterone should relieve edema
- Spironolactone and eplerenone
- Used as a diuretic and in heart failure
- Highly bound to plasma proteins
- Side effects: GI upsets; mimicry of sex hormones
- Sodium Channel Blockers
- Triamterene and amiloride
- Blocks sodium transport channels, decreasing Na/K exchange
- Side effects: K retention; renal stones, increased uric acid
- Loop Diuretics
- Causes the most diuresis
- Useful in emergency situations
- Acts on ascending loop of Henle
- Most common is furosemide; others are bumetanide and torsemide
- Inhibits Na/K/2Cl cotransport, reducing reabsorption
- Increases excretion of Na, K, and Ca
- Decreases renal vascular resistance
- Increases renal blood flow
- Increases prostaglandin synthesis - may increase renal blood flow
- Used in treating acute pulmonary edema in heart failure
- Used to treat hyperkalemia nd hypercalcemia
- Side effects: ototoxicity; hypermagnesemia; hyperurecemia; potassium depletion
- Carbonic Anhydrase Inhibitors
- Acetazolamide and methazolamide
- Weak diuretic
- Works on proximal tubule
- Decreases ability to exchange Na for H for bicarbonate
- Used to treat glaucoma
- Acetazolamide (Diamox) 2 250mg tablets
- Dorzolamide and brinzolamide are used topically
- Also treats pseudotumor cerebri and mountain sickness
- Side effects: metabolic acidosis, K depletion, renal stones, drowsiness, paresthesia
- Avoid in patients with cirrhosis