(First Aid) Renal (Pharmacology)
Osmotic diuretic that increases urine flow by increasing tubular fluid osmolarity and drawing out water in the porixmal tubule and descending loop
Anuria and CHF
When are the contraindications for Mannitol
Carbonic anhydrase inhibitor that causes self-limited NaHCO3 diuresis.
Hyperchloremic metabolic acidosis (ACIDazolamide causes ACIDosis), inc NH3, sulfa aleergy
What are the 3 potentially bad side effects of acetazolamide
Furosemide (Loop diuretic)
Inhibitor of Na/K/2Cl symporter in thick ascending loop. Makes medulla less hypertonic so urine can't be concentrated.
Ca (Loops lose calcium - because lumen is less positive so it doesn't drive Ca and Mg resoprtion)
What ion does furosemide make you lose?
OH DANG! (Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa) Nephritis (interstitial), Gout)
What is the mnemonic for the side effects of furosemide?
Ethacrynic acid (loop diuretic but not a sulfa)
What do you substitute for furosemide in your patient with a sulfa allergy or that has gout?
Inhibits NaCl reabsorption in early distal tubule. Causes reduced diluting capacity. Don't give to sulfa allergy patients
Ca (dec excretion)
Hydroclorothiazide causes increased amounts of what ion to build up?
HyperGLUC (Hypokalemic metabolic alkalosis, hyponatremia, hyperGlycemia, hyperLipidemia, hyperUricemia, and hyperCalcemia)
Mnemonic for side effects of Hydrochlorothiazide
Spironalactone and Eplerenone
Competitive aldosterone receptor antagonists in cortical collecting tubule. Blocks loss of K+ (2)
K sparing diuretic that blocks Na+ channels in the cortical collecting tubule.
The K+ STAys (K+, spironalactone, Triamterone, Amiloride)
Mnemonic for remembering the K+ sparing diuretics' names
Hyperkalemia, Endocrine effects (gynecomastia, antiandrogen, etc)
Side effects for K sparing diuretics
All diuretics (including CA inhibitors)
Which diuretics inc urine NaCl
All (except K+ sparing)
What diuretics increase urine K+
CA inhibitors, K+ sparing diuretics
Which diuretics make your blood more acidic (dec pH)?
Loop diuretics and thiazides
Which diuretics make your blood more alkalotic (inc pH)?
Which diuretics inc urine calcium (dec plasma calcium)?
Which diuretics dec urine calcium (inc blood calcium)?
-prils (captopril, enalapril, lisinopril)
ACE inhibitors that dec angiontensin II and prevent bradykinin inactivation (leads to vasodilation). Will se increased renin levels in blood (loss of feedbackinhibition)
Losartan (no cough)
Angiotensin II receptor antagonist
Cough, Feta l renal damage, Hyperkalemia (avoid with bilateral renal artery stenosis)
What are the side effects of ACE inhibitors (3)?
Diuretics that inhibit V2 ADH receptor by blocking AQP insertion in the collecting duct
Demeclocine (bone/teeth abnormalities), lithium (nephrogenic diabetes insipidus)
Ca inhibitors (NaHCo3 inc is key)
Diuretic that causes urinary: NaCl (inc), NaHCO3 (inc), K+ (inc) Ca (inc), Body pH (dec)
Diuretic that causes urinary: NaCl (inc - biggest), dec NaHCo3, K+ (inc, Ca (inc), Body pH (inc)
Thiazides (dec Ca is key)
Diuretic that causes urinary: NaCl (inc), K+ (inc), Ca (dec), body pH (inc, no change in urinary excretion of NaHCO3)
K+ sparing diuretcs (dec K is key)
Diuretic that causes urinary: NaCL (inc), K+ (dec), no change in Ca or K, and body pH (dec)