Today one of our superstar attendings joined us for lecture. Dr. Sambandam, nephrologist extraordinaire.
The topic was Diuretics Resistance. He went over basic pharmacology of diuretics, mechanisms of resistance, clinical syndromes of resistance and management of diuretic resistance.
Just a few highlights with the powerpoint below:
– Bioavailibilty of torsemide and bumetanide >> furosemide
– Mechanism of diuretic resistance? Excess Na intake, ineffective dosing frequency, increased distal nephron transport
– Resistance but thinking noncompliance? signs include requirement for large doses of diuretic for GFR, requirement for large K replacement
– Renal insufficiency? Will need higher dose of diuretic as tub secretion is diminished and renal mass is reduced
– Natriuresis is directly proportional to GFR
– And so much more! Including slides like this: