Diuretics

Question 1

What are 4 renal functions?

Answer 1

REEM

• Regulatory
• Excretory
• Endocrine
• Metabolism

Question 2

What does an Aquaretic do?

Answer 2

Causes water loss without electrolyte loss

Question 3

How do Loop diuretics causes Calcium loss, allowing use in treating hypercalcaemia?

Answer 3

• Inhibit Na-K-Cl2 channel
• Less K+ movement through Apical ROMK channel
• Less paracellular transport of Ca and Mg

Question 4

How do Thiazides increase Ca reabsorption?

Answer 4

• Inhibit Na-Cl symport
• Less Na in DCT cell
• More Na enters through Basal Na-Ca antiport
• More Ca absorbed through same channel

Question 5

ADH antagonists are Aquaretics.

Name 1

Answer 5

Tolvaptan

Lithium also has this effect

Question 6

How do Alcohol and Caffeine have diuretic action

Answer 6

Alcohol: Inhibits ADH release

Caffeine: Increases GFR and decreases Na reabsorption

Question 7

List 6 ADRs of thiazides

Answer 7

• Gout
• ED
• Raised LDL and TAG levels
• Hypercalcaemia
• Hyperglycaemia
• Hyponatraemia (not a long term issue)

Question 8

List 4 ADRs of Furosemide

Answer 8

• Ototoxicity
• Raised LDL and TAG levels
• Alkalosis
• Gout

Question 9

List 4 ADRs effects of Spironolactone

Answer 9

• Hyperkalaemia
• Impotence
• Painful gynaecomastia
• Menstrual irregularities

Question 10

Which loop diuretic can cause Myalgia?

Answer 10

Bumetanide

Question 11

What drugs are usually used to treat Decompensated liver disease

Answer 11

1st line- Spironolactone

• Loop diuretics

Question 12

What are Bartter’s and Gitelman’s Syndromes?

Answer 12

Bartter’s: Blockage of Na-K-Cl2 channel in LoH

Gitelman’s: Blockage of Na-Cl channel in DCT

Question 13

What is Liddle’s Syndrome?

Answer 13

Permanent stimulation of ENac channels

Thus hypertension and raised serum Na