MindMap Gallery Pharmacology - diuretics
This is a mind map about 24-diuretics, including proximal tubule: CA inhibitors, collecting duct: potassium-sparing diuretics, dehydration drugs/osmotic diuretics, etc.
Edited at 2023-12-13 15:42:19One Hundred Years of Solitude is the masterpiece of Gabriel Garcia Marquez. Reading this book begins with making sense of the characters' relationships, which are centered on the Buendía family and tells the story of the family's prosperity and decline, internal relationships and political struggles, self-mixing and rebirth over the course of a hundred years.
One Hundred Years of Solitude is the masterpiece of Gabriel Garcia Marquez. Reading this book begins with making sense of the characters' relationships, which are centered on the Buendía family and tells the story of the family's prosperity and decline, internal relationships and political struggles, self-mixing and rebirth over the course of a hundred years.
Project management is the process of applying specialized knowledge, skills, tools, and methods to project activities so that the project can achieve or exceed the set needs and expectations within the constraints of limited resources. This diagram provides a comprehensive overview of the 8 components of the project management process and can be used as a generic template for direct application.
One Hundred Years of Solitude is the masterpiece of Gabriel Garcia Marquez. Reading this book begins with making sense of the characters' relationships, which are centered on the Buendía family and tells the story of the family's prosperity and decline, internal relationships and political struggles, self-mixing and rebirth over the course of a hundred years.
One Hundred Years of Solitude is the masterpiece of Gabriel Garcia Marquez. Reading this book begins with making sense of the characters' relationships, which are centered on the Buendía family and tells the story of the family's prosperity and decline, internal relationships and political struggles, self-mixing and rebirth over the course of a hundred years.
Project management is the process of applying specialized knowledge, skills, tools, and methods to project activities so that the project can achieve or exceed the set needs and expectations within the constraints of limited resources. This diagram provides a comprehensive overview of the 8 components of the project management process and can be used as a generic template for direct application.
diuretics
Proximal tubule: CA inhibitor
Acetazolamide
Inhibit carbonic anhydrase activity: inhibit HCO3-reabsorption
application
glaucoma
acute mountain sickness
alkalize urine
Correct alkalosis
Adverse reactions
Sulfonamide allergy
Acidosis
urinary stones
Lose K
Thick segment of ascending branch of medullary loop: loop diuretics
Severe
Furosemide (furosemide), bumetanide, ethacrynic acid (diuretic acid)
Inhibits Na-K-2Cl symport; reduces renal concentration and dilution functions
Oral; iv (emergency)
effect
diuretic
Inhibit Na-K-2Cl symport; K, Ca, Mg reabsorption↓
HypoNa, hypochloral alkalemia, hypokalemia, hypomagnesemia
Add potassium-sparing diuretics
High-dose furosemide inhibits CA activity and HCO3-reabsorption↓
dilate blood vessels
Expand blood vessels, increase venous blood volume, and reduce pulmonary congestion
HF
Increase renal blood flow
ARF
Promote PG synthesis
NSAIDs inhibit PG synthesis and interfere with diuretic effects: nephrotic syndrome, liver disease
application
Acute pulmonary edema, cerebral edema
Expansion reduces blood return volume
severe edema
Severe edema where other diuretics are ineffective, such as heart, liver, or renal edema
ARF, CRF
Diuresis - flushing the renal tubules
Dilation of renal blood vessels--increased GFR--increased urine output
High-dose furosemide for the treatment of CRF
hypercalcemia
Accelerate the excretion of poisons
Rescue of renally excreted drugs (barbiturates, salicylates, bromines)
Adverse reactions
Hypovolemia, hypokalemia, Na, Mg, Ca, Cl
Hypokalemia can enhance the toxicity of cardiac glycosides to the heart and may induce hepatic coma in patients with cirrhosis.
Ototoxicity
Tinnitus, hearing loss or temporary deafness, avoid concomitant use of aminoglycoside antibiotics
Enetalic acid>Frusemide>Bumetanide
Hyperuricemia: competes with uric acid in the body for excretion
But rarely gout
high blood sugar
LDL, TG↑, HDL↓
Nausea and vomiting, gastrointestinal bleeding may occur in large doses
allergy
Rash, eosinophilia
Distal tubule: Thiazides
Medium effect
Hydrochlorothiazide, indapamide
Orally administered; competes with uric acid for secretion
Inhibits Na-Cl symport
effect
Diuretic (mild and long-lasting)
Inhibit Na-Cl: Low Na Increased K excretion: low K
Inhibit CA: Increased HCO3- excretion
Promote PTH: Increase Ca reabsorption and reduce Ca deposition in the lumen
antidiuretic
Reduce urine output in diabetes insipidus and relieve thirst
step down
Early stage: diuresis, reducing blood volume
Late stage: vasodilation
application
Edema
Mild and moderate cardiac edema has better curative effect
Use with caution in patients with renal failure
When using thiazides in severe hepatic coma, care should be taken to prevent hypokalemia, which may lead to hepatic coma.
HBP
Combined use of antihypertensive drugs
Pituitary diabetes insipidus
Idiopathic hyperuria with urinary stones
Adverse reactions
electrolyte imbalance
Low K, Na, Mg, Ca
Increase blood sugar, increase lipids, increase uric acid
Hyperuricemia: use with caution in patients with gout
Hyperglycemia and hyperlipidemia: use with caution in DM and hyperlipidemia *Inhibit insulin secretion
allergy
subtopic
Collecting Duct: Potassium-Sparing Diuretics
Weak, slow, long-lasting
ALD receptor antagonists
Spironolactone, eplerenone (highly selective for ALD receptors)
The distal tubule terminal and collecting duct directly antagonize the aldosterone system and inhibit Na-K exchange.
It only works when the aldosterone system is present in the body: not effective in adrenalectomized animals
application
Refractory edema with increased aldosterone: nephrotic syndrome, cirrhosis and ascites
Combined with thiazides, it can increase urine output and preserve potassium: patients with edema and HBP
congestive heart failure
Diuretic, reducing swelling, inhibiting myocardial fibrosis
Adverse reactions
Hyperkalemia → Renal insufficiency is contraindicated
Sex hormone-like effects: hirsutism, breast development, etc.
Renal tubular epithelial Na channel blockers
Chlorbendidine, Amiloride
Potassium-sparing diuretic effect on adrenalectomized animals
Dehydration drugs/osmotic diuretics
Mannitol, sorbitol, hypertonic glucose
Features
It is difficult to enter the tissue through capillaries after intravenous injection
easy filtration through renal tubules
Not easily reabsorbed by renal tubules
application
dehydration
Cerebral edema and glaucoma: the first choice drug to reduce intracranial pressure
Osmotic Diarrhea: Detoxification
diuretic
Prevent acute renal failure
Adverse reactions
Water and electrolyte imbalance
Will increase the burden on the heart: chronic cardiac insufficiency is contraindicated
Injecting too quickly may cause transient headache, dizziness, and blurred vision.