Diuretic Agents

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Can you name the Diuretic Agents ?

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Toxicities: metabolic acidosis, renal stones, hyperammonemia in cirrhotics
Antagonist at V1a and V2 ADH receptors. Reduces water reabsorption and increases plasma Na concentration
Toxicity: Hyperkalemia, gynecomastia
Not a sulfonamide but has typical loop activity and some uricosuric action loop diuretic
Reduces reabsorption of HCO3- in the kidney causing self limited diuresis
MOA: Blocks epithelial sodium channels in collecting tubules
Toxicities: Hypokalemic metabolic alkalosis, hyperuricemia, hyperglycemia, hyponatremia
Clinical applications: glaucoma, mountain sickness, edema with alkalosis
Toxicities: Ototoxicity, hypovolemia, K wasting, hyperuricemia, hypomagnesemia
Toxicity: Nausea, vomiting, headache. May enhance congestive heart failure or cause pulmonary edema.
Pharmacologic antagonist of aldosterone
Inhibition of Na/K/Cl transporter in the ascending limb of Henle's loop
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Like spironolactone, more selective for aldosterone receptor
Popular for use with loop agents for synergistic effects
MOA: Inhibition of the enzyme prevents dehydration of H2CO3 and hydration of CO2
Toxicity: Hyperkalemic metabolic acidosis
MOA: Physical osmotic effect on tissue water distribution because it is retained in the vascular compartment
Used for hypertension, mild heart failure, nephrolithiasis, nephrogenic diabetes insipidus
Used for peripheral edema, hypertension, acute hypercalcemia, hyperkalemia, acute renal failure, anion overdose
Mechanism like amiloride, much less potent, more toxic
Sulfonamide similar to thiazide
Toxicity: Infusion site reactions
Only parenteral thiazide available
MOA: Inhibition of NaCl transporter in the distal convoluted tubule

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