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renal pharm

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mannitol
MOA: osmotic diuretic, increases osmolarity of the TF, resulting in increased urine flow; ADR: pulmonary edema, dehydration; I: drug overdose, shock, increased intracranial/intraocular pressure; CI in CHF/anuria
Acetazolamide
MOA: carbonic anhydrase inhibitor--causes NaHCO3 diuresis and decreases total bicarbonate stores; ADR: hyperchloremic metabolic acidosis, NH3 toxicity, sulfa allergy, neuropathy; IND: glaucoma, urine alkalinization, metabolic alkalosis, altitude sickness
Furosemide
loop diuretic; MOA: inhibits cotransport of Na, Cl, and K in the ascending LOH, decreases hypertonicity of medulla inhibiting urinary concentration, stimulates production of PGE dilating afferent arteriole; ADR: ototoxicity, hypokalemia, dehydration, sulfa allergy, interstitial nephritis, gout; IND: gout, edema, hypertension
Ethacrynic acid
loop diuretic; MOA: phenoxyacetic acid derivative with same MOA as furosemide; ADR: ototoxicity, hypokalemia, dehydration, interstitial nephritis, hyperuricemia; used in pts with SULFA ALLERGY!
HCTZ
MOA: inhibits NaCl cotransport in the early DCT; ADR: hyokalemic metabolic alkalosis, hyperglycemia, hyperlipidemia, hyperuricemia, hyponatremia, hypercalcemia; IND: hypertension, nephrogenic DI, idiopathic hypercalciuria, CHF; SULFA ALLERGY!!
Spironolactone
K sparing diuretic; MOA: aldosterone antagonist in the cortical collecting tubule; ADR: hyperkalemia, gynecomastia, anti androgenic effects; IND: hyperaldo, K+ deficiency, CHF
Triamterene/amiloride
K sparing diuretic; MOA: inhibit Na channels in the CCT; ADR: hyperkalemia; IND: CHF, hyperaldo, hypoK
ACE inhibitor
MOA: inhibit conversion of angI-ang II, inhibit destruction of bradykinin; ADR: cough, angioedema, pregnancy problems, taste changes, hypotension, rash, proteinuria, hyperkalemia; AVOID in b/l renal stenosis due to inhibition of VC of efferent arteriole (red. GFR); IND: htn, CHF, diabetic renal disease