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DIURETICS Part II - What Do They Do

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DIURETICS Part II - What Do They Do

  1. 1. DIURETICS How do they work? WHAT DO THEY DO? When do I use them? How do I use them?
  2. 2. Na-K-2Cl SYMPORT INHIBITORS <ul><li>Also Called: </li></ul><ul><ul><li>Loop Diuretics </li></ul></ul><ul><ul><li>High Ceiling Diuretics </li></ul></ul>Ethacrynic Acid Torsemide Bumetanide Furosemide
  3. 3. THERAPEUTIC EFFECTS Increase Na Excretion to 25% of Filtered Load Treatment for Oliguric ARF Increase Ca Excretion Treatment for Hypercalcemia Impair Free Water Reabsorption Treatment for Hyponatremia Increase Venous Capacitance Treatment for Pulmonary Edema Increase Urine Volume Treatment for Severe Edema
  4. 4. ADVERSE EFFECTS Hypomagnesemia Metabolic Alkalosis Hypokalemia Profound ECFV Depletion Hyperglycemia Hyperuricemia Ototoxicity Hypocalcemia
  5. 5. OTHER EFFECTS Increase & Redistribute RBF Increase Renin Release Release PGs Block TGF
  6. 6. Na-Cl SYMPORT INHIBITORS <ul><li>Also Called: </li></ul><ul><ul><li>Thiazide Diuretics </li></ul></ul><ul><ul><li>Thiazide-Like Diuretics </li></ul></ul>Chlorthalidone Metolazone Chlorothiazide Hydrochlorothiazide
  7. 7. THERAPEUTIC EFFECTS Increase Na Excretion to 5% of Filtered Load Treatment for Hypertension Decrease Ca Excretion Treatment for Calcium Nephrolithiasis Treatment for Nephrogenic Diabetes Insipidus Treatment for Mild Edema
  8. 8. ADVERSE EFFECTS Hypomagnesemia Metabolic Alkalosis Hypokalemia ECFV Depletion Hyperglycemia Hyperuricemia Hyponatremia Hypercalcemia Impotence Increased LDL
  9. 9. Na CHANNEL INHIBITORS <ul><li>Also Called: </li></ul><ul><ul><li>K-Sparing Diuretics </li></ul></ul>Amiloride Triamterene
  10. 10. THERAPEUTIC EFFECTS Enhance Natriuresis Caused by Other Diuretics Block Na Channels Treatment for Liddle’s Syndrome Prevent Hypokalemia Used in Combination with Loop & Thiazide Diuretics Treatment for Lithium-Induced Diabetes Insipidus
  11. 11. ADVERSE EFFECTS Renal Stones Interstitial Nephritis Megaloblastosis Hyperkalemia Hyperkalemia Amiloride Triamterene
  12. 12. MINERALOCORTICOID RECEPTOR ANTAGONISTS <ul><li>Also Called: </li></ul><ul><ul><li>K-Sparing Diuretics </li></ul></ul><ul><ul><li>Aldosterone Antagonists </li></ul></ul>Spironolactone Eplerenone
  13. 13. THERAPEUTIC EFFECTS Enhances Natriuresis Caused by Other Diuretics Blocks Aldosterone Treatment for Primary Hyper-aldosteronism Prevents Hypokalemia Used in Combination with Loop & Thiazide Diuretics Treatment for Edema of Liver Cirrhosis Treatment for Hypertension Treatment for Heart Failure
  14. 14. ADVERSE EFFECTS Impotence Gynecomastia Metabolic Acidosis Hyperkalemia Hirsutism CNS Side Effects Peptic Ulcers Gastritis Menstrual Irregularities Deepening of Voice

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