Which of the following diuretics would be most useful in the acute treatment of a comatose patient with traumatic brain injury and cerebral edema?
(A) Acetazolamide
(B) Amiloride
(C) Chlorthalidone (D) Furosemide (E) Mannitol

A 62-year-old man with advanced prostate cancer is admit- ted to the emergency department with mental obtundation. An electrolyte panel shows a serum calcium of 16.5 (normal 8.5–10.5 mg/dL). Which of the following therapies would be most useful in the management of severe hypercalcemia?
(A) Acetazolamide plus saline infusion
(B) Furosemide plus saline infusion
(C) Hydrochlorothiazide plus saline infusion (D) Mannitol plus saline infusion
(E) Spironolactone plus saline infusion

A 60-year-old patient complains of paresthesias and occa- sional nausea associated with one of the drugs she is taking. She is found to have hyperchloremic metabolic acidosis. She is probably taking
(A) Acetazolamide for glaucoma
(B) Amiloride for edema associated with aldosteronism (C) Furosemide for severe hypertension and heart failure (D) Hydrochlorothiazide for hypertension
(E) Mannitol for cerebral edema

A 70-year-old woman is admitted to the emergency depart- ment because of a “fainting spell” at home. She appears to have suffered no trauma from her fall, but her blood pres- sure is 120/60 when lying down and 60/20 when she sits up. Neurologic examination and an ECG are within normal limits when she is lying down. Questioning reveals that she has recently started taking “water pills” (diuretics) for a heart condition. Which of the following drugs is the most likely cause of her fainting spell?
(A) Acetazolamide
(B) Amiloride
(C) Furosemide
(D) Hydrochlorothiazide (E) Spironolactone

A 58-year-old woman with lung cancer has abnormally low serum osmolality and hyponatremia. A drug that increases the formation of dilute urine and is used to treat SIADH is (A) Acetazolamide
(B) Amiloride
(C) Desmopressin
(D) Ethacrynic acid
(E) Furosemide
(F) Hydrochlorothiazide (G) Mannitol
(H) Spironolactone
(I) Triamterene
(J) Tolvaptan

A graduate student is planning to make a high-altitude climb in South America while on vacation. He will not have time to acclimate slowly to altitude. A drug that is useful in prevent- ing high-altitude sickness is
(A) Acetazolamide (B) Amiloride
(C) Demeclocycline (D) Desmopressin (E) Ethacrynic acid

The answer is E in both
الاول يعاني من Severe hypokalemia و HTN وماعنده edema ف نكدر ننطيه spiro لان اضرب عصفورين بحجارة وحدة هم اقلل من ضغطه وهم ازيد من K serum
الثاني عدها little knee edema و k serum is normal ف افضل شي تنطيه كذلك من عائلة K STAy مثل Triam.
صح راح يصير شوية Hyperkalemia لكن تكدر تسيطر عليه

Sotalol used it in Ischemic heart disease and post_MI
يعني اخذله سابقا MI وراها صارلة Arrhythmias تكدر تستخدم ذا

Ibutilide act on funny current channles may cause torsade de pointes.

Verapamil and Diltiazem used it in SVT especially if he has Angina and or HTN

Na+ channel blockers (class I) may cause
phenomenon >>>use dependance
ذني الي ركز عليهن د حيدر بمحاضرته ابد شرحه مو زين بالفيديو 🥲🥲🥲🥲🥲
اخوان الArrhythmia بكل بساطتها يعني contraction فوك contraction فيصير اكو لخبطه ماكو نظم بين ضربه وضربه ثانية فيصير abnormal HR بحيث من تجي تحس الRadial pulse تشوفون ماكو فد انتظام بين ضربات القلب اما تتاخر وحده عن الثانية كلش او تصير ملاكمة وحده فوك ثانية
هسه حسو بالRadial pulse مالتكم تشوفون اكو نظم بين ضربه وضربه

#1pharma

Patients with hepatic impairment often excrete large amounts of ammonia in the urine in the form of ammonium ion. If they are given acetazolamide, alkalinization of the urine pre- vents conversion of ammonia to ammonium ion. As a result, they may develop hepatic encephalopathy because of increased ammonia reabsorption and hyperammonemia.
اكو سوال كلش مهم ليش ممنطي Acetazolmide لجماعة Liver disease هذا جوابه لان Actazolamide راح يسوي الUrine at very alkaline mediaوهذا يمنع تحويل NH3 to NH4 وبالتالي يسوي Hepatic encephalopathy (HE)



The major application of loop diuretics is in the treatment of edematous states (eg, heart failure, ascites, and acute pulmonary edema). They are sometimes used in hypertension if response to thiazides is inadequate, but the short duration of action of loop diuretics is a disadvantage in this condition. A less common but important application is in the treatment of severe hypercalcemia. This life-threatening condition can often be managed with large doses of furosemide together with parenteral volume and elec- trolyte (sodium and potassium chloride) replacement.


Chronic renal calcium stone formation can sometimes be controlled with thiazides because they reduce urine calcium concentration. Potassium wasting caused by chronic therapy with loop or thia- zide diuretics, if not controlled by dietary potassium supplements, usually responds to these drugs. They are also available in combi- nation with a thiazide in a single pill.
Aldosteronism (eg, the elevated serum aldosterone levels that occur in cirrhosis) is an important indication for spironolactone. Aldosteronism is also a feature of heart failure, and spironolactone and eplerenone have been shown to have significant long-term benefits in this condition.
The most important toxic effect of potassium-sparing diuretics is hyperkalemia. These drugs should never be given with potas- sium supplements. Other aldosterone antagonists (eg, angiotensin [ACE] inhibitors and angiotensin receptor blockers [ARBs]), if used at all, should be used with caution in patients taking potassium-sparing diuretics. Spironolactone can cause endocrine alterations including gynecomastia and antiandrogenic effects. Eplerenone has less affinity for gonadal steroid receptors.

K spering >>>>>Hyperkalemic metabolic acidosis

Mannitol and several other osmotic agents are useful in reducing intraocular pressure in acute open angle glaucoma and intracranial pressure in neurologic conditions and decrease brain volume .
Movement of water from the intracellular compartment to the extracellular may cause hyponatremia and pulmonary edema. As the water is excreted, hypernatremia may follow
.
#ذني كلهن مواضع اسئلة
اسئلة د ايمان ذني جانت تلح بيهن
... Spirnolactone ....give for Addison disease
خطأ هو مننطيه يعني هو هذا الexcept
...thiaziad.....increase risk for hip fracture
هو خطأ بالعكس تقلل لان ثثثثثييييززززاييييد سسسسسييييزيييد من الكالسيوم يعني
Increase Ca reabsorption by kidney

كل المعلومات مال مصدرنا عن Diuretic صراحة اكو معلومات يحجيها المصدر ارتب بهواي من ملازمنا التعبانة🙄🙄😐