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robbypowell's version from 2016-10-24 22:25

Diuretics

Question Answer
Thiazide diuretics and loop/high ceiling diuretics affect K levels how?K wasting... so induce hypokalemia (inducing arrhythmias and glycoside toxicity)
If you're taking glycosides (Digoxin or Digitoxin) then what is the best type of diuretics to use?K sparing (hypokalemia induces arrhythmia or toxicity when taking glycosides)
What are the three main types of Diuretics?thiazide diuretics (hydrocholorothiazide), loop/high ceiling diuretics (furosemide), & K sparing diuretics
mercaptomerin, an organic mercurial diuretic, is inactive in (acidic/alkaline) urineAlkaline
How do xanthines such as caffeine & theophylline act as diuretics?inc CO = inc Renal blood flow (which is 25% of CO)
_______, an Osmotic diuretic, stays in vasculature and pulls water into BV = removes excess water from areas such as edema in the brainMannitol (osmotic diuretic) (other type diuretic)
T/F: Mannitol (osmotic diuretic) gets filtered in renal glomeruli and water follows and gets excretedTrue
T/F: Mannitol (osmotic diuretic) gets excreted in the proximal tubule and water followsFalse (water does follow Mannitol, but it is filtered by the glomerulus, not actively excreted)
70-80% of glucose is reabsorbed in what part of nephron?proximal tubule
T/F: water diffuses through the Ascending loop of henleFalse (impervious to water in order to dilute urine)
T/F: At the Proximal/distal tubule, H is exchanged for Na (H in Na out)False (Na in H out)
T/F: At the Proximal/distal tubule, Na is exchanged for H (Na in H out)True
Aldosterone affects the amount of _____ absorbed by the bodyNa (Na absorbed, K excreted)
______ is a hormone that has the effect of Absorbing Na and exhchanging it for KAldosterone
Anti-diuretic Hormone (vasopressin) acts on what part of the Nephron?Collecting ducts (collecting tubule)
What class of diuretic inhibits Na/Cl cotransport in early segment of distal convoluted tubule & relaxes vasc smooth muscle cells (chronic hypotensive effect)THIAZIDE diuretics
What class of diuretic results in more Na staying in the tubule and thus more water being excreted with it?Thiazide diuretic (e.g. Hydrochlorothiazide)
Do Thiazide diuretics affect potassium levels? if so, how?Yes --> HYPOKalemia (also results in HYPERcalcemia)
Do Thiazaide diuretics affect Calcium levels? if so, how?Yes ----> HYPERcalcemia (also results in HYPOkalemia)
T/F: Thiazide diuretics are contraindicated for patients with gout because they cause decreased uric acid excretionTrue
T/F: Thiazide diuretics are indicated for patients with gout because they do increase uric acid excretionFalse (contraindicated b/c they decrease excretion)
T/F: Xerostomia is an adverse effect of Thiazide diureticsTrue
T/F: Xerostomia is not associated with Thiazide diureticsFalse
What class of Diuretics act on of Na, K, 2Cl cotransporter in medullary ascending loop of henle?Loop Diuretics (e.g. Furosemide)
What class of diuretics act on Na/Cl co-transporter in early segment of distal convoluted tubule?Thiazide diuretics (e.g. hydrochlorothiazide)
Use of what class of Diuretics can cause an Acute Hypotensive effect (in addition to a chronic hypotensive effect)?Loop diuretics (e.g. Furosemide)
T/F: Loop diuretics (e.g. Furosemide) are indicated for patients with gout because they do increase uric acid excretionFalse (contraindicated b/c they decrease excretion)
T/F: Loop diuretics (e.g. Furosemide) are contraindicated for patients with gout because they cause decreased uric acid excretionTrue (more pronounced than Thiazides?)
What class of diuretics has the adverse effects of Hypokalemia, hyperuricemia, and hypocalcemia?Loop Diuretic (e.g. Furosemide) same as Thiazides for first two, but Hypocalcemia for Loop diuretics (and hypercalcemia for thiazide)
What class of diuretics has the adverse effects of Hypokalemia, hyperuricemia, and hypercalcemia?Thiazide Diuretic (e.g. Hydrochlorothiazide) same as Loop diuretics for first two, but Hypocalcemia for Thiazides (and hypocalcemia for Loop diuretics like Furosemide)
Ototoxicity and deafness are associated with what class of diuretics?Loop Diuretics (transient with Furosemide; permanent with ethacyrinic acid)
Which Loop Diuretic has the adverse effect of TRANSIENT Ototoxicity and Deafness?Furosemide
Which Loop Diuretic has the adverse effect of PERMANENT Ototoxicity and Deafness?Ethacyrinic acid
Which class of diuretics is contraindicated with sulfa drugs (aminoglycosides) because it interacts with ototoxic drugs?Loop Diuretics (esp Furosemide and Ethacyrinic acid)
Of the Potassium-Sparing Diuretics, ______ & ________ dec Na absorption in late distal tubules and collecting ducts, and have less K secretionAmiloride and Triamterene
Of the Potassium-Sparing diuretics, ________ acts as an aldosterone receptor antagonist → promote Na excretion and K reabsorptionSpironolactone
Spironolactone is an _________ receptor antagonist (→ promote Na excretion and K reabsorption)Aldosterone
2 major therapeutic uses for diureticsEdema & Hypertension
What class of diuretic could be used to treat idiopathic hypercalciuria?thiazide diuretics
What class of diuretic could be used to treat hyper calcemia?loop diuretics
What class of diuretic could be used to treat glaucomaCarbonic anhydrase inhibitors
What class of diuretic could be used as an anticonvulsantAcetazolamide
An important implication for dentistry concerning loop diuretics is their induction of _________ (systemic ion level) that can potentiate toxicity if _____ ______ must be usedHypokalemia; Digitalis Glycosides
_______ (systemic ion level) with use of epinephrine can increase chances of arrhythmiaHypokalemia
Hypokalemia (induced by loop diuretics) with use of epinephrine can increase chances of ________ (heart effect)Arrhythmia
memorize

some effects of thiazides and loop diuretics

Question Answer
T/F: Both thiazides and loop diuretics increase sodium excretiontrue
T/F: Both thiazides and loop diuretics decrease sodium excretionfalse (both increase)
T/F: Both thiazides and loop diuretics increase potassium excretiontrue
T/F: Both thiazides and loop diuretics decrease potassium excretionFalse (both increase)
T/F: Both thiazides and loop diuretics increase chloride excretiontrue
T/F: Both thiazides and loop diuretics decrease chloride excretionfalse (both increase)
T/F: Both thiazides and loop diuretics increase calcium excretionFalse (Thiazide decreases, Loop increases excretion of Calcium)
T/F: Thiazide increases excretion of Calcium while Loop diuretics decrease calcium excretionFalse ((other way around
T/F: Thiazides decrease excretion of Calcium, while Loop diuretics increase calcium excretionTrue***
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