Prepare for your exams
Get points
Guidelines and tips
Sell on Docsity
Docsity AI

Prepare for your exams

Study with the several resources on Docsity

Earn points to download

Earn points by helping other students or get them with a premium plan

Guidelines and tips

Sell on Docsity

Docsity AI

Log in Sign up

Prepare for your exams

Study with the several resources on Docsity

Find documents

Prepare for your exams with the study notes shared by other students like you on Docsity

Search for your university

Find the specific documents for your university's exams

Docsity AINEW

Summarize your documents, ask them questions, convert them into quizzes and concept maps

Explore questions

Clear up your doubts by reading the answers to questions asked by your fellow students

Earn points to download

Earn points by helping other students or get them with a premium plan

Share documents

20 Points

For each uploaded document

Answer questions

5 Points

For each given answer (max 1 per day)

All the ways to get free points

Get points immediately

Choose a premium plan with all the points you need

Study Opportunities

Choose your next study program

Get in touch with the best universities in the world. Search through thousands of universities and official partners

Community

Ask the community

Ask the community for help and clear up your study doubts

Free resources

Our save-the-student-ebooks!

Download our free guides on studying techniques, anxiety management strategies, and thesis advice from Docsity tutors

Pharmacology of Diuretics, Sulfonylureas, and Lipid-Lowering Drugs, Summaries of Pharmacology

Royal College of Surgeons in Ireland-Medical University of Bahrain (RCSI MUB)Pharmacology

An overview of various diuretics, including loop diuretics and thiazide diuretics, and their side effects. Additionally, it covers sulfonylureas as second-line treatment for diabetes and the mechanisms of action and side effects of K+-sparing drugs, ACE-inhibitors, ARBs, calcium-channel blockers, and beta-blockers. Furthermore, it discusses the treatment of hyperlipidemia with HMG-CoA reductase inhibitors (statins), fibrates, bile acid binding resins, and stanols / sterols.

Typology: Summaries

2021/2022

Uploaded on 11/29/2022

its-manar 🇧🇭

2 documents

1 / 5

This page cannot be seen from the preview

Don't miss anything!

13-14

Loop Diuretics

•inhibit Na/K/Cl carrier

•inhibit transport of NaCl out of tubule

•Increase water excretion

•Given orally and intravenously

•Acts within 1 hour orally

Side-effects of loop diuretics

•Hypokalaemia (low potassium)

•Hyperglycaemia

•Loop diuretics may increase LDL

•Ototoxicity, deafness, tinnitus, vertigo*

•Increased Mg++ and Ca++ excretion may result in hypomagnesemia and

hypocalcemia

•Overuse of loop diuretics can cause serious depletion of total body Na+ and

dehydration

•Can cause hyperuricemia leading to gout

•Usually reversible, but high doses IV can make it permanent. Hair cell

damage for both hearing and balance.

Thiazide Diuretics

•Act on distal tubule

•Bind to Na/Cl co-transport

•Orally and IV

Side effects:

•Low Na+, Mg++, K+

•Hyperuricaemia

•Hyperglycemia

•Hypercholesterolemia

•Impotence

•Pancreatitis

Classic example – hydrochlorothiazide

Sulfonylureas and meglitinides (Second line treatment)

•Stimulate insulin release by beta cells (Requires functioning b-cells)

•Thiazides ACTIVATE (SUR)

•Less insulin released

Examples glimepiride (Amaryl), glipizide (Glucotrol)

K+-sparing drugs

•Spironolactone

Discover Summaries of Pharmacology Royal College of Surgeons in Ireland-Medical University of Bahrain (RCSI MUB)

Partial preview of the text

Download Pharmacology of Diuretics, Sulfonylureas, and Lipid-Lowering Drugs and more Summaries Pharmacology in PDF only on Docsity!

13- Loop Diuretics

inhibit Na/K/Cl carrier
inhibit transport of NaCl out of tubule
Increase water excretion
Given orally and intravenously
Acts within 1 hour orally Side-effects of loop diuretics
Hypokalaemia (low potassium)
Hyperglycaemia
Loop diuretics may increase LDL
Ototoxicity, deafness, tinnitus, vertigo*
Increased Mg++^ and Ca++^ excretion may result in hypomagnesemia and hypocalcemia
Overuse of loop diuretics can cause serious depletion of total body Na

and dehydration

Can cause hyperuricemia leading to gout - Usually reversible, but high doses IV can make it permanent. Hair cell damage for both hearing and balance. Thiazide Diuretics
Act on distal tubule
Bind to Na/Cl co-transport - Orally and IV Side effects:
Low Na

, Mg ++ , K

Hyperuricaemia
Hyperglycemia
Hypercholesterolemia
Impotence - Pancreatitis Classic example – hydrochlorothiazide Sulfonylureas and meglitinides (Second line treatment)
Stimulate insulin release by beta cells (Requires functioning b-cells)
Thiazides ACTIVATE (SUR)
Less insulin released Examples glimepiride (Amaryl), glipizide (Glucotrol) **K

-sparing drugs**

Spironolactone

Limited diuretic action Side effects
Hyperkalaemia
Gynaecomastia Amiloride
ENaC blocker
No NR effects Side effects
Hyperkalaemia
Gynaecomastia ACE-Inhibitors
Common agents: Lisinopril Uses
First line treatment of hypertension
Heart failure
After heart attack
Renal protection in diabetes mellitus Side effects
Dry Cough - Taste disturbance – first-dose hypotension – hyperkalaemia – renal impairment Contraindication
Pregnancy and bilateral renal artery stenosis For your information drugs that end with (pril) they are for ACE-INHIBITORS Angiotensin Receptor Blockers (ARBs)
Common agents : Valsartan Side-effects & Contraindications
Like ACEI except no cough Clinical uses
Like ACEI
Generally used if patients develop cough on ACEI or to ensure patient compliance For your information drugs that end with (sartan) they are for (ARBs) Calcium-Channel Blockers
Examples Dihydropyridines Nifedipine (short-acting) Amlodipine (long-acting)
Non-Dihydropyridines Diltiazem Verapamil

Contraindications with Beta-blockers

Vasospastic angina - Unstable heart failure - Insulin-dependent diabetes mellitus (can be used with caution) - Bronchial asthma - Peripheral vascular disease - 2 nd & 3 rd degree Heart block Alpha-blockers
Common agents: doxazosin, prazosin (The drugs that end with (zosin) usually for Alpha-blockers)
Block alpha receptors in the blood vessels, lowering blood pressure Uses
For uncontrolled hypertension
For enlarged prostate (BPH) Side-effects
Fatigue
Postural hypotension Treatment of Hyperlipidemia
HMG-CoA reductase Inhibitors
Bile Acid Binding Resins
Fibrates
Fish Oils
Stanols / Sterols Statins
The statins are the most effective and best-tolerated agents for treating dyslipidemia
These drugs are competitive inhibitors of HMG-CoA reductase Side-Effects of Statins
Myopathy
Diabetes
Risk of haemorrhagic stroke If CK levels are significantly elevated do not use a statin Fibrates
Gemfibrozil
Fenofibrate
Mechanism of action unclear Indication:
treatment of hypertriglyceridemia, reduced LDL by 10%, raised HDL by 10% and decreased TG by 35%, with reduction in CHD events.
Adverse effects & Drug interactions

N.B. Combination of Gemfibrozil and Statin can increase the risk of myotoxicity
Most common side effects GI disturbance
Elevated liver enzymes Bile-Acid Sequestrants
Cholestyramine
Colestipol
These are amongst the oldest of the hypolipidaemic drugs
Safest as not absorbed from the gut
Bind bile acids, since 95% of bile acids are reabsorbed, deplete pool of bile acids and thus hepatic cholesterol declines, stimulating increase in LDL receptor Bile Acid Binding Resins
American Lipid Research Clinics Trial
13% decrease in plasma cholesterol
20-25% fall in heart disease over 7 years
Occasionally used as an addition to a statin if patient fails to respond to statin alone
Can be used in patients 11-20 years of age Side-effects
Not absorbed - Bloating and Dyspepsia
Interfere with absorption of drugs, thus administer all drugs 1 hour before or 3-4 hours after administration of cholestyramine

Pharmacology of Diuretics, Sulfonylureas, and Lipid-Lowering Drugs, Summaries of Pharmacology

Related documents

Partial preview of the text

Download Pharmacology of Diuretics, Sulfonylureas, and Lipid-Lowering Drugs and more Summaries Pharmacology in PDF only on Docsity!