A 70-year-old man with acute decompensated heart failure presents with dyspnea, orthopnea, and peripheral edema. Vital signs show BP 160/95 mmHg, HR 105/min, RR 22/min, and SpO2 88% on room air. He receives intravenous furosemide. Over several days, dyspnea improves, but he develops tinnitus and hearing loss. Labs reveal serum potassium 2.8 mEq/L, pH 7.52, and HCO3− 32 mEq/L. Chest X-ray shows improved pulmonary edema. Which mechanism best explains these adverse effects?
- A)Inhibition of carbonic anhydrase in proximal tubule
- B)Antagonism of aldosterone receptor in collecting duct
- C)Osmotic retention of water in proximal tubule and descending limb
- D)Blockade of Na Cl cotransporter in distal convoluted tubule
- E)Inhibition of Na K 2Cl cotransporter in thick ascending limbGABARITO
Explicação
Loop diuretics inhibit the Na K 2Cl cotransporter in the thick ascending limb of the loop of Henle. They are potent diuretics used in edema states and can cause ototoxicity, hypokalemia, metabolic alkalosis, and increased calcium excretion. Ver explicação completa e trilha adaptativa →