| A | B |
|---|
| fucntions of renal system | cleansing of extracellular fluid, maintenance of ph balance, excretion of metabolic wastes & foreign subtances |
| fucntion most affected by diuretics | cleansing of ecf, composition and volume of ecf |
| renal processes | filtration, reabsorption, active tubular secretion |
| where non-selective filtration occurs | glomerulus |
| where diuretics mainly work | selective reabsorption |
| where selection active tublular secretion occurs | proximal convoluted tubule 1 |
| 65% of soidum & chloride reabsorbed here | prox. convuluted tubule 2 |
| urine becomes concentrated, then na & cl reabsorbed in ascending part of this | loop of Henle |
| 10% na & cl reabsorbed | early distal convoluted tubule |
| processes at late distal conv. tubule | na/k exchange, regulation of urine concentration |
| stimulates reabsortpion of na from distal nephron & causes potassium to be secreted | aldosterone |
| aldosterone influnces what | na-k exchange in distal convulted tubule |
| aldosterone | adrenal cortex mineralcortoid |
| acts on collecting ducts to regulate concentration of water | ADH |
| without ADH what happens | too much water is excreted |
| mechanism of action of diuretics | blocade of sodium/chloride reabsorption |
| adverse effects of diuretics | hypovalemia, acid/base imbalance & electrolyte imbalance |
| furosemide (lasix) is an example of | loop diuretics |
| where loop diruectis act | ascending loop ofHenle |
| metabolism for furosemide | hepatic |
| adverse effects of lasix | hypokalemia, hypotension, hypovalemia, hyponatremia, hypomagnesemia, dehydration, ototoxicity, photsensitivity, hyperlipidemia, hyperuricemia |
| laxix pregnancy category | C |
| drug interactions with lasix | anticoagulants, dig, ototoxic drugs, potassium sparing diuretics, lithium, antihypertensives, nsaids |
| lasix & hctz contraindicated in | patients with sulf allergies |
| use lasix with caution in | patients with thiazide allergies |
| #1 choice of treatment in htn | hctz |
| hctz doesn't work well with | patients in renal failure/low gfr |
| hctz is less likely than lasix to cause | ototoxicity and electrolyte disturbances |
| prototype | hydrodiuril |
| hctz works where? | distal convoluted tubule |
| when should diuretcs be taken | early in the day |
| hctz pregnancy category | B |
| how potassium sparing drugs work | increase urine production, decrease potasisum exceretion |
| spironolactone (aldactone) works in the | distal nephron |
| how long can aldosterone take to work | 2 days |
| po lasix starts when & finishes when | 60 min & lasted 8 hrs. |
| IV lasix starts/finishes | 5 min. lasts 2 hrs. |
| adverse effects of aldactone | hyperkalemia, gynecomastia, hirsutism, menstrual iregularities |
| difference beween spironolactone & triamterene | triamterene directly inhibits exchange mechanism |
| combination of hctz & triamterne | Maxzide/Dyazide |
| side effects of triamterene | hyperkalemia, n/v, leg cramps, dizziness, blood dyscrasias |
| prototypical osmotic diuretic | mannitol |
| how does mannitol work? | uses osmotic force to inhibit passive reabsorption of h20 & pulls water from tissues into vascular compartment |
| mannitol | no effect on electrolytes/can cause chf |
| another example of loop diuretic | ethacrynic acid |
| another example of thiazide diuretic | indapamide |
| another example of potassium sparing | amiloride |
| mannitol | used as prophylaxis for renal failure |
| triamterene works more quickly than spironolactorne because | works directly on the mechanism |
| thiazide diuretics may cause | diabetes insipidus |
| how does thiazide affect glucose | can cause an increase in this |
