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Diuretic Classes

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There are 5 main types of diuretic classes with different mechanisms of action, site of action, and side effect profiles. ⁠ ⁠ 1) Loop diuretics work on the loop of Henle (as the name implies)⁠ 2) Osmotic diuretic work on the glomerulus⁠ 3) Thiazides work on distal convoluted tubule⁠ 4) Carbonic anhydrase work on the proximal tubule⁠ 5) Potassium-sparing diuretics (aldosterone antagonists and sodium channel blockers) work on the distal convoluted tubule⁠ and collecting ducts

Hypernatremia, Signs & Symptoms of

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🖇️ High levels of sodium can lead to a condition called hypernatremia, where the serum sodium concentration > 145 mEq/L (> 145 mmol/L). ⁠
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🖇️ Sodium is a dominant cation in extracellular fluid and necessary for the maintenance of intravascular volume. When there is a large increase in sodium in the serum, the signs and symptoms often relate to fluids as you can see with today’s mnemonic.⁠
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🖇️ The human body maintains sodium and water homeostasis by concentrating the urine secondary to the action of antidiuretic hormone (ADH) and increased fluid intake by a powerful thirst response.⁠

Valproate Side Effects

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💊 Valproic acid is used in seizures, bipolar disorder, and migraine prophylaxis. It works by increasing the availability of gamma (y)-aminobutyric acid (GABA), an inhibitory neurotransmitter. ⁠
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🖇️ Divalproex sodium is a compound of sodium valproate and valproic acid. Divalproex dissociates to valproate in the GI tract. ⁠
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🖇️ Use special caution with the combination of valproic acid and lamotrigine due to the risk of serious rash called Stevens-Johnson Syndrome. ⁠