Thiazide and Thiazide-Like Diuretics #5
Thiazide and Thiazide-Like Diuretics #5
Adverse Effects (cont.)
o
Decreased calcium excretion
o
Altered blood glucose levels
o
Urine will be slightly alkalinized
Drug-to-Drug Interactions
o
Cholestyramine or colestipol
o
Digoxin
o
Antidiabetic agents
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Prototype Thiazide and Thiazide-Like
Diuretics
Prototype Thiazide and Thiazide-Like
Diuretics
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Question #1Question #1What is the action of thiazide diuretics?
A. Blocks the chloride pumpB. Blocks the sodium pumpC. Blocks the potassium pumpD. Blocks the carbonic anhydrase pump
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Answer to Question #1
Answer to Question #1
A. Blocks the chloride pump
Rationale: Thiazide and thiazide-like diuretics act to block
the chloride pump. Chloride is actively pumped out of the
tubule by cells lining the ascending limb of the loop of
Henle and the distal tubule.
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Loop Diuretics #1
Loop Diuretics #1
Furosemide (
Lasix
)
o
Most commonly used; less powerful than new drugs;
larger margin of safety for home use
Bumetanide (
Bumex
) and Torsemide (
Demadex
)
o
New drugs; more powerful than Lasix
Ethacrynic acid (
Edecrin
)
o
First loop diuretic introduced, used less frequently in
the clinical setting
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Loop Diuretics #2
Loop Diuretics #2
Actions
o
Block the chloride pump in the ascending loop of
Henle
o
This causes reabsorption of sodium and chloride
Indications
o
Acute CHF
o
Acute pulmonary edema
o
Edema associated with CHF
o
Edema associated with renal or liver disease
o
Hypertension
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Loop Diuretics #3
Loop Diuretics #3
Pharmacokinetics
o
Metabolized and excreted primarily through the urine
Contraindications
o
Allergy
o
Electrolyte depletion
o
Anuria
o
Severe renal failure
o
Hepatic coma
o
Pregnancy and lactation
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Loop Diuretics #4
Loop Diuretics #4
Caution
o
SLE, gout, and diabetes mellitus
Adverse Effects
o
Related to the imbalance in electrolytes and fluid
o
Hypokalemia
o
Alkalosis
o
Hypocalcemia
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Loop Diuretics #5
Loop Diuretics #5
Drug-to-Drug Interactions
o
Aminoglycosides or cisplatine
o
Anticoagulation
o
Indomethacin, ibuprofen, salicylates, or NSAIDs
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Prototype Loop Diuretics
Prototype Loop Diuretics
Copyright © 2017 Wolters Kluwer • All Rights Reserved
Carbonic Anhydrase Inhibitors #1
Carbonic Anhydrase Inhibitors #1
These drugs are used as adjuncts to other diuretics when
a more intense diuresis is needed
o
Acetazolamide (
Diamox
)
o
Methazolamide (generic).
