If infiltration occurs, stop the drug but do not remove the iv device. Diuretics are the drugs which increase the urine outflow and also increase the urine production. Potassiumsparing diuretics pharmacology the essential. Including uses, types, side effect, and drug interaction. And ironically some were even harder to memorize than the drug itself. Diuretics also called water pills are drugs that increase urine production in the kidneys, promoting the removal of salt and fluid from the body. Loop diuretics are indicated for resistant hypertension in patients with heart failure, chronic kidney disease, and in those at risk of hyperkalaemia. Antihypertensive drugs bja education oxford academic. Zvara, md antiischemic drug therapy antiischemic drug therapy during anesthesia is indicated whenever evidence of myocardial ischemia exists. Studying the pharmacology of antihypertensive drugs doesnt need to be difficult. Clinical pharmacology in diuretic use american society. 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. Several other drugs alter water excretion predominantly. 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.
There is a third class of diuretic that is referred to as potassiumsparing diuretics. 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. 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. Pharmacology made ridiculously easy mnemonics for medical. This can be very useful in intractable oedema but care should be taken with the dose. The subgroups of the sodiumexcreting diuretics are based on these sites and processes in the nephron. 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. Here i have provided mnemonic for dmards classification. Brater, drug induced electrolyte disorders and use of diuretics in. The clinical pharmacology of potassiumsparing diuretics is important.
So, i always tried making mnemonics of my own and it worked because my brain works on a higher dimension. 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. A single renin inhibitor has recently been added to the drugs used in. The free pdf ebook has 14 sections and these are listed as below. Pharmacology is a study of drugs, especially of the ways in which they react biologically at receptor sites in the body. Diuretics are among the most commonly prescribed drugs, and play an important role in the treatment of heart failure and hypertension. General pharmacology gp01 a a drug is given at a dose of 50 mgkg to a 70 kg man. They exert most of their therapeutic effects through inhibiting the reabsorption of sodium at different sites along the nephron of the kidney. Diuretics work on the kidneys to eliminate water and electrolytes thus they have. Ps psychotherapeutic drugs cd cardiovascular drugs en endocrine drugs md miscellaneous drugs st statistics coding letters. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
Recommended diuretic causes more side effects than similar. Drugs include corticosteroids, amphotericin and theophylline in particular, which, if used together with diuretics, can exacerbate hypokalaemia. Diuretics, commonly called water pills, are drugs that promote diuresis, that is increased production of urine. Learn pharmacology quiz 1 diuretics with free interactive flashcards. Diuretics pdf diuretics pharmacology pdf diuretics classification pdf. Increase dose of diuretic combine loop diuretic and thiazide with persistant fluid retention. Potassiumsparing diuretics include drugs that block apical sodium channels amiloride and triamterene and those that antagonize mineralocorticoid receptors spironolactone and eplerenone. Clinical pharmacology of antihypertensive therapy for the. The use of these drugs carries a risk of hyperkalaemia, particularly in patients with impaired renal function or who are taking other potassiumsparing agents. Thus, pharmacology looks at how drugs effect the functions of living body.
Pharmacology and clinical use of diuretics katie herndon, pharm. Diuretic agents increase the urine formation, by influencing any of the processes involved in urine formation. Loop diuretics act on the nephron mainly in the thick ascending links of the loop of henle. More than 99% of the glomerular filtrate is reabsorbed in the tubules. 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. Contact the medical control physician immediately for orders. 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.
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. 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. Site of action of diuretic drugs kidney international. 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. Reducing the amount of fluid in the blood vessels results in reduction in blood pressure. 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.
This blog post is an effort dedicated to making pharmacology easier just a bit and fun quite unlikely by the use of mnemonics. 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. A comparative pharmacological study of diuretic drugs. Multiple choice questions on drugs used in treating hypertension are presented. 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. These substances increase the excretion of water, sodium, and chloride through urine. Potassiumsparing diuretics are medications that help remove extra fluid volume from the blood through increased urination. This causes more sodium and water to pass into the collecting duct and be excreted in the urine. Spironolactone is a weak diuretic that takes several days to take effect. Renal function, urea and electrolytes should also be closely observed. Another drug that has a powerful diuretic effect is metolazone. Capitals indicate lifethreatening, underlines indicate most frequent. Kd tripathi essentials of pharmacology free download pdf.
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. Thiazide diuretics are the oldest class of antihypertensive drugs still in use. 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. 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. Unlike loop and thiazide diuretics, some of these drugs do not act directly on sodium transport. Diuretics are drugs that primarily increase the excretion of sodium.
Thiazides improve cardiovascular outcomes, including stroke, heart failure, coronary events, and death 36,37. Each type works in a distinct way and in different parts of the kidney. Once the underlying physiological mechanisms are understood, the likely side effect and drug interaction profiles begin to fall into place and make more sense. They are filtered at the glomerulus some are also sec by the weak acid sec. Antihypertensive drugs are organized around a clinical indicationthe need to treat a diseaserather than a receptor type. Chlorthalidone, the guidelinerecommended diuretic for lowering blood pressure, causes more serious side effects than hydrochlorothiazide, a similarly effective diuretic, according to. Easy to remember pharmacology mnemonics with pictures. A new nonsteroidal mineralocorticoid blocker, finerenone, is currently in phase 3 clinical trials. Choose from 500 different sets of pharmacology quiz 1 diuretics flashcards on quizlet. To some extent, they also increase the volume of urine produced by the kidneys. 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. They are classified by their mechanism of action as loop diuretics, carbonic anhydrase inhibitors, thiazides, osmotic diuretics, and potassiumsparing diuretics.
Funny and easy to remember pharmacology mnemonics personally, i find majority of the preexisting pharmacology mnemonics boring as they consist of redundant riddles. With enough time and even more effort, you too can commit all antihypertensive drug classes to memory. F, edema, pct,dct introduction all soluble constituents of blood minus the plasma proteins and lipids are filtered at the glomerulus. Pharmacology of antihypertensive drugs your complete guide. Principles of pharmacology basic concepts and clinical application new york.
The effects of the diuretic agents are predictable from knowledge of the function of the segment of the nephron in which they act. The effect the drug elicits on body systems is both chemical and psychological effect placebo and both these aspects fall under. 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. Starting with the physiology of the kidney, it progresses to explain how diuretics actually work, via symports on the inside of the renal tubules. Diuretic drug groups the diuretics acting in these segments each have different moa. Some drugs in this class antagonize the actions of aldosterone aldosterone receptor antagonists at the distal segment of the distal tubule. Topic wise pharmacology questions and answers pdf 2020. Faqs information on diuretic drugs and the diseases and conditions they are prescribed for.
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