Diuretic agents increase the urine formation, by influencing any of the processes involved in urine formation. A very common medical school and post graduate question, this very short video goes through all the major classes of diuretics and explains clearly where and how they work to induce a diuretic. There is a third class of diuretic that is referred to as potassiumsparing diuretics. Zvara, md antiischemic drug therapy antiischemic drug therapy during anesthesia is indicated whenever evidence of myocardial ischemia exists. Thiazide diuretics are the oldest class of antihypertensive drugs still in use. Diuretics are the drugs which increase the urine outflow and also increase the urine production. Increase dose of diuretic combine loop diuretic and thiazide with persistant fluid retention. This blog post is an effort dedicated to making pharmacology easier just a bit and fun quite unlikely by the use of mnemonics. Diuretic drug groups the diuretics acting in these segments each have different moa. Unlike loop and thiazide diuretics, some of these drugs do not act directly on sodium transport. If infiltration occurs, stop the drug but do not remove the iv device. Reducing the amount of fluid in the blood vessels results in reduction in blood pressure.
Each type works in a distinct way and in different parts of the kidney. Including uses, types, side effect, and drug interaction. Important drug interactions nsaids salt decongestants probenecid hyperkalemia induced by ksparing diuretics enhanced ototoxicity of loop diuretic diminished diuretic response ace inhibitors betablockers k supplements ksparing diuretics heparin ototoxic drugs. Potassiumsparing diuretics pharmacology the essential. To some extent, they also increase the volume of urine produced by the kidneys by blocking the absorptive capacity of cells lining the renal tubules for sodium, intravascular volume and the eventual leaking of fluid from capillaries is reduced and prevented. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Diuretics also called water pills are drugs that increase urine production in the kidneys, promoting the removal of salt and fluid from the body. Pharmacology and clinical use of diuretics katie herndon, pharm.
General pharmacology gp01 a a drug is given at a dose of 50 mgkg to a 70 kg man. Diuretics, commonly called water pills, are drugs that promote diuresis, that is increased production of urine. Thiazides improve cardiovascular outcomes, including stroke, heart failure, coronary events, and death 36,37. Pharmacology made ridiculously easy mnemonics for medical. Before considering the specific action of diuretic drugs on the transport of water and electrolytes in the renal tubule, brief attention should be given to their effects on glomerular filtration since such effects may influence to a major extent the magnitude of the diuresis. For this reason, it is frequently taken alongside another diuretic such as a loop or thiazide diuretic to counteract potassium loss and promote overall diuresis. The subgroups of the sodiumexcreting diuretics are based on these sites and processes in the nephron. By blocking the absorptive capacity of cells lining the renal tubules for sodium, intravascular volume and the eventual leaking of fluid from capillaries is reduced and prevented.
Studying the pharmacology of antihypertensive drugs doesnt need to be difficult. And ironically some were even harder to memorize than the drug itself. Mnemonics are a great way to help ease the pressure on your nerves and they can be very helpful for remembering drug names and their side effects. Loop diuretics act on the nephron mainly in the thick ascending links of the loop of henle. With enough time and even more effort, you too can commit all antihypertensive drug classes to memory. This ebook for the pharmacology by lippincott is one of the most trusted books by medical students and examiners which is the reason why newer editions are being made almost each year for new drugs and advancements in medicine. Contact the medical control physician immediately for orders. So, i always tried making mnemonics of my own and it worked because my brain works on a higher dimension.
The clinical pharmacology of potassiumsparing diuretics is important. This can be very useful in intractable oedema but care should be taken with the dose. Another drug that has a powerful diuretic effect is metolazone. Learn pharmacology quiz 1 diuretics with free interactive flashcards. Potassiumsparing diuretics are medications that help remove extra fluid volume from the blood through increased urination. Loop diuretics are indicated for resistant hypertension in patients with heart failure, chronic kidney disease, and in those at risk of hyperkalaemia. Distribution of drugs to specific tissues a is independent of blood flow to the organ b is independent of the solubility of the drug in that tissue c depends on the unbound drug concentration gradient between blood and tissue d is increased for drugs that are strongly bound to plasma proteins e has no effect on the halflife of the.
Thus, pharmacology looks at how drugs effect the functions of living body. Pharmacology is a study of drugs, especially of the ways in which they react biologically at receptor sites in the body. Drugs include corticosteroids, amphotericin and theophylline in particular, which, if used together with diuretics, can exacerbate hypokalaemia. Pepper, rn, cns, phd, faan the wide variety of firstline agents available for managing high blood pressure include diuretics, beta adrenergic receptor blockers, alpha adrener gic receptor blockers, angiotensin converting en. Renal function, urea and electrolytes should also be closely observed. Potassiumsparing diuretics include drugs that block apical sodium channels amiloride and triamterene and those that antagonize mineralocorticoid receptors spironolactone and eplerenone. These substances increase the excretion of water, sodium, and chloride through urine. Recommended diuretic causes more side effects than similar. Here i have provided mnemonic for dmards classification. Pharmacology of antihypertensive drugs your complete guide.
Capitals indicate lifethreatening, underlines indicate most frequent. Diuretics pdf diuretics pharmacology pdf diuretics classification pdf. Cleveland clinic journal of medicine volume 82 number 8 august 2015 527 the thiazide diuretic hydrochlorothiazide and the thiazidelike diuretic chlorthalidone are two old drugs that are. More than 99% of the glomerular filtrate is reabsorbed in the tubules. They are classified by their mechanism of action as loop diuretics, carbonic anhydrase inhibitors, thiazides, osmotic diuretics, and potassiumsparing diuretics. Ps psychotherapeutic drugs cd cardiovascular drugs en endocrine drugs md miscellaneous drugs st statistics coding letters.
Topic wise pharmacology questions and answers pdf 2020. Diuretic drugs are typically classified first according to their predominant site of action along the nephron and second by the mechanism by which they inhibit transport. Diuretics are used to remove inappropriate water volume in animals with edema or volume overload, correct specific ion imbalances, and reduce blood pressure and pulmonary capillary wedge pressure see table. Several other drugs alter water excretion predominantly. Faqs information on diuretic drugs and the diseases and conditions they are prescribed for. Easy to remember pharmacology mnemonics with pictures. Clinical pharmacology of antihypertensive therapy for the. Funny and easy to remember pharmacology mnemonics personally, i find majority of the preexisting pharmacology mnemonics boring as they consist of redundant riddles. This causes more sodium and water to pass into the collecting duct and be excreted in the urine. Although loop diuretics have diuretic efficacy greater than that of thiazide or thiazidelike agents, effects on blood pressure are relatively brief and reflex stimulation of the reninangiotensin system tends to counter the fall in blood pressure. Clinical pharmacology in diuretic use american society. F, edema, pct,dct introduction all soluble constituents of blood minus the plasma proteins and lipids are filtered at the glomerulus. Some drugs in this class antagonize the actions of aldosterone aldosterone receptor antagonists at the distal segment of the distal tubule. To some extent, they also increase the volume of urine produced by the kidneys.
The use of these drugs carries a risk of hyperkalaemia, particularly in patients with impaired renal function or who are taking other potassiumsparing agents. The effect the drug elicits on body systems is both chemical and psychological effect placebo and both these aspects fall under. The loop diuretics furosemide, bumetanide, and torsemide act from the lumen to inhibit the nak2cl cotransporter nkcc2, encoded by slc12a1 along the thick ascending limb and. Site of action of diuretic drugs kidney international.
Diuretics work on the kidneys to eliminate water and electrolytes thus they have. Choose from 500 different sets of pharmacology quiz 1 diuretics flashcards on quizlet. They are filtered at the glomerulus some are also sec by the weak acid sec. A single renin inhibitor has recently been added to the drugs used in. Multiple choice questions on drugs used in treating hypertension are presented. The effects of the diuretic agents are predictable from knowledge of the function of the segment of the nephron in which they act. Starting with the physiology of the kidney, it progresses to explain how diuretics actually work, via symports on the inside of the renal tubules. Antihypertensive drugs are organized around a clinical indicationthe need to treat a diseaserather than a receptor type.
The free pdf ebook has 14 sections and these are listed as below. Spironolactone is a weak diuretic that takes several days to take effect. Principles of pharmacology basic concepts and clinical application new york. Brater, drug induced electrolyte disorders and use of diuretics in. The drugs covered in this unit have a variety of mechanisms of action including diuresis, sympathoplegia, vasodilation, and antagonism of angiotensin, and many agents are available in most categories. The site of action for thiazides is the nacl cotransporter in the distal convoluted tubule of the nephron, which is responsible for around 5% of total sodium reabsorption. Once the underlying physiological mechanisms are understood, the likely side effect and drug interaction profiles begin to fall into place and make more sense. Diuretics are among the most commonly prescribed drugs, and play an important role in the treatment of heart failure and hypertension. Always ask yourself these 5 questions when you see a drug name to help you understand how the drug works, your role as a nurse, and what information will be asked on an exam about the drug. Paramedic pharmacology manual 3 infiltration precautions before administering any iv medication or solution, the paramedic must check the iv site for patency and signs of infiltration andor phlebitis. A new nonsteroidal mineralocorticoid blocker, finerenone, is currently in phase 3 clinical trials.
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