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29 Cards in this Set
- Front
- Back
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Type of Diuretic
Furosamide? |
Loop Diuretic
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Type of Diuretic
Butetanide |
Loop Diuretic
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Type of Diuretic
Pinetanide |
Loop Diuretic
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Type of Diuretic
Ethacrynic |
Loop Diuretic
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Loop Diuretic
Where does it act? Causes? |
Thick segment of Loop of Henle
15-25% excretetion of filtered Na+ torrential Flow |
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Loop Diuretics
Mechanism? |
Compete for Cl- binding site on the Na/K/Cl cotransporter inhibiting sodium and chlorine reabsorption.
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Clinical Use of loop diuretics?
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1. Hypertension complicated by renal impairment
2. salt and water overload associated with; acute pulmonary odema, chronic heart failure, renal failure, nephrotic syndrome, liver cirrhosis |
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Thiazide drugs?
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Bendrofluazide, hydrochlorothiazide, cyclpenthaizide
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Where do thiazides act?
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early distal tubule, do not affect thick segment of the loop of henle
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Mechanism of thiazides?
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Na pump is the primary active transport in the distal tubule, Na and Cl enter by a co transport system that is inhibited by thiazides
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Clinical use of thiazides?
Side effect? |
Hypertension
Mild heart failure severe resistant oedema prevent Ca containing kidney stones nephrogenic diabetes isipidus Side effect - erectile dysfunction |
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Unwanted effects of thiazides and loop diuretics?
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Potassium loss - hypokalemia
mechanism - 1. blockade of na reabsorption in early parts of nephron and increased delivary to collecting duct 2. high flow rate produced by diuretics favours K excretion |
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Potassium sparing diuretics
2 examples? where they act? |
Na channel blockers
aldosterone antagonists collecting duct |
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Site of action of Na blockers?
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Late distal tubule and Collecting duct - block apical Na channels loss of p.d. (lumen -ve in respect to late distal tubule) causing a loss oin driving force for K secretion from tubule. net effect Na reabsorption and decreased K secreation.
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2 Na chanel blockers?
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Amiloride, Triamterene
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Aldosterone?
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secreted (from adrenal cortex) in response to inc. angiotensin II (secreted in response to low plasma vol.) or inc. plasma K. Increases Na reabsorption and K secretion in cortical collecting duct leading to decreased Na excretion and increased K excreation.
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Name 2 aldosterone antagonists?
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Spironolactone, eplerenone
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Mechanism of action of aldosterone antagonists?
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Inhibits the effects of aldosterone:
1. inc. synthesis of K channels and Na/K ATPase, Na/H cotransporter, H ATPase 2. inc. production of ATP |
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Uses of potassium sparing diuretics?
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used with K losing diuretics to prevent hypokalemia
to treat aldosteronism (Conns syndrome- high BP, low K levels cuased by excess aldosterone), heart failure, Hypertension |
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Side effects of potassium spari ng diuretics?
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Hyperkalemia
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Carbonic Anhydrase inhibitors site of actions?
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proximal tubule
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name a carbonic anhydrase inhibitor?
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acetazolamide
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clinical uses of carbonic anhydrase inhibitors?
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glaucoma, congestive heart failure, prevents formation of uric acid and cystine stones
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mechanism of osmotic diuretics?
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freely filtered at glomerulus, incr. osmotic pressure of tubular fluid and reduce reabsorption of water, reduce luminal Na and thus reabsorption
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where to osmostic diuretics act?
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regions freely permable to water - proximal tubule, descending loop of henle, collecting tubules
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Name an osmotic diuretic?
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Mannitol usually given intravenously
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clinical uses of osmotic diuretics?
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extreme cases of glaucoma and cerebral edema, incr. plama osmolarity without ntering brain or eye
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mechanism of caffine as diuretic?
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incr. renal blood flow => incr. GFR decreasing Na reabsorption
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mechanism of alcohol as diuretic?
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inhibits release of ADH from pituritary gland
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