Chapter 2 BNF (Oedema and Vascular Disease) Flashcards
Which loop diuretic causes gout?
Furosemide
Which diuretic is used for ascites liver failure?
Spironolactone
Which diuretic is used in cerebral oedema?
Mannitol
which diuretic causes the least aggrevation in diabetes?
Indapamide
How do diuretics work?
Inhibit sodium reabsorption at different parts of the renal tubular system.
LOOP: inhibits sodium/potassium/chloride ATPase in the loop of Henley
THIAZIDES: inhibit sodium/chloride channel in distal conv tubule
How do loops and thiazides affect electrolytes?
LOOP: hypokalaemia, hyponatraemia, hypocalcaemia, hypomagnesaemia
low chloride
THIAZIDE: same but hypercalcaemia
Loop diuretic side effects?
ototoxicity
acute urinary retention (cautioned in BPH)
Thiazide side effects?
GI disturbance, impotence, high LDL, triglycerides
Diabetes, gout
Which thiazide can be used when eGFR is below 30?
Metalazone
What are the two Bendroflumethiazide doses?
HF - 5mg
Hypertension - 2.5mg
Duration of action and onset of Loop and Thiazide diuretics?
loop onset 1 hr
duration 6 hours
thiazide onset 1-2 hours
thiazide duration 12-24hours
Which diuretic is least likely to cause acute urinary retention?
Chlortalidone
How do potassium sparing diuretics work
inhibit sodium in the distal conv tubule
Triamtene
Amiloride
Side effects of Aldesterone antagonists?
Gynaecomastia
Hypertrichosis
libido changes
hyperuricaemia
How is gravitational oedema treated?
Short term diuretics
try alternatives first eg stockings raising legs and movement
