When do we use acetazolamide?
- Altitude sickness: Breathing faster and deeper blows off CO2, causing resp alkalosis; body compensates this by getting rid of bicarbonate but this takes days. Giving this med does it faster. 2. Alkalinize the urine. 3. Metabolic alkalosis. 4. Chronic glaucoma: because bicarbonate production draws water into the eye to form aqueous humor.
What are the side effects of acetazolamide?
- Metabolic acidosis. 2. Sulfa allergies (it is a sulfa drug).
Where does Mannitol work on and what does it do?
It works on the proximal convoluted tubule, and works as an osmotic diuretic; causes an osmolar load that stays in the filtrate, preventing reabsorption of free water, causing excretion of free water.
-It raises serum osmolarity, raising serum Sodium.
What are the side effects of manitol?
Dehydration.
Which conditions make the use of mannitol prohibited?
- Anuric renal failure. 2. Congestive Heart Failure.
What are the 2 diuretics that are used in glaucoma? Which one is used in acute cases and which one for chronic cases?
- Mannitol is used in acute angle-closure cases of glaucoma. 2. Acetazolamide in chronic cases of glaucoma.
When do we use mannitol?
- Shock. 2. Drug overdose. 3. Acute angle-closure glaucoma. 4. Elevated ICP (intracranial pressure) (in IV).
What are three loop diuretics?
- Furosemide. 2. Bumetanide. 3. Torsemide. 4. Ethancrynic acid. (1 to 3 are sulfonamide diuretics. Ethacrynic acid is not a sulfonamide.)
What is the mechanism of loop diuretics?
They inhibit the Na+/2Cl-/K+ symporter in the thick ascending limb, making the urine more dilute.
-They cause loss of calcium. “Loops lose calcium” (thiazides retain calcium).
When are loop diuretics indicated?
CHF. Pulmonary edema. Nephrotic syndrome. Cirrhosis. (Use thiazides to treat hypertension).
What are the side effects of loop diuretics?
Ototoxicity. Nephrotoxicity. Hypokalemia. Dehydration. Gout. Sulfa allergy.
What are some Thiazide diuretics? Which one is the most widely used?
- Chlorothiazide. 2. Hydrochlorothiazide (HCTZ). 3. Chlorthalidone. 4. Metolazone. HCTZ is the most used.
How do thiazides work?
They work by inhibiting the sodium and chloride reabsorption in the early distal convoluted tubule by inhibiting the Na+/Cl- symporter. They retain thiazides retain Ca2+.
When are thiazides indicated for?
- Hypertension.
- Idiopathic hypercalciuria.
- Nephrogenic diabetes insipidus.
What are the side effects of thiazide use?
- Hypokalemia.
- Hyponatremia.
- Hyperglycemia.
- Hyperlipidemia.
- Hyperuricemia.
- Hypercalcemia. “Loops lose calcium, thiazides retain calcium”.
- Sulfa allergies.
What are some potassium-sparing diuretics?
[Potassium, please have a SEAT]
Spironolactone. Eplerenone. Amiloride. Triamterene.
Which of the potassium-sparring drugs are aldosterone antagonists?
Spironolactone and Eplerenone.
What are the three drugs given to patients with CHF?
- Specific beta-blocker.
- ACE inhibitor (or and ARB: angiotensin receptor inhibitors).
- Aldosterone antagonists.
What are the side effects of potassium-sparing drugs?
- Hyperkalemia.
- Spiranolactone can antagonize androgen and cause gynecomastia.
- Menstrual irregularities.
Almost all diuretics will increase urinary sodium chloride except?
Acetazolamide.
Almost all of the diuretics will increase urinary potassium except?
Potassium-sparing diuretics.
Which types of diuretics will cause acidosis?
Carbonic anhydrase inhibitors and potassium-sparing diuretics.
Which type of diuretics will cause alkalosis and why?
Loops and thiazides: loss of sodium chloride causes hypochlorimia, which in turn causes reduced excretion of bicarbonate, causing the alkalosis.
What type of diuretic is tiramterene?
Potassium-sparing diuretic.
