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
💊 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.
🖇️ Divalproex sodium is a compound of sodium valproate and valproic acid. Divalproex dissociates to valproate in the GI tract.
🖇️ Use special caution with the combination of valproic acid and lamotrigine due to the risk of serious rash called Stevens-Johnson Syndrome.
🖇️ High levels of sodium can lead to a condition called hypernatremia, where the serum sodium concentration > 145 mEq/L (> 145 mmol/L).
🖇️ 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.
🖇️ 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.
Ever been on corticosteroids before? Due to the activation of the sympathetic system (“fight or flight”), your body responds with an increase in blood pressure, blood sugar, mood changes, and blood volume. With short term use, side effects are minor but can vary depending on their dose and how long they are taken.