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33 Cards in this Set

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Major site of bicarbonate reabsorption
Promixmal convoluted tubule
Segment with Na, K, 2Cl cotransporter
Thick ascending limb
In the TAL potassium is pumped via cotransporter into the cell and diffuse back into the lumen withou an anion. What is this necessary for?
Creates positive potential to drive Ca and Mg reabsporption.
PTH controlls the Ca reabsorption in what segment?
Distal convoluted tubule
This diuretic is an exception in that it enters cell from the basolateral side instead of being filter or secreted
Spironolactone

binds to the aldosterone receptor and antagonizes its effects
Site of action for acetazolamide
Proximal tubule

a brush border and intracellular carbonic anhydrase inhibitor
Acetazolamides effects on sodium and potassium
CA produces less H to countertransport with Na, so Na excretion goes up and thusly, so does K when it reaces the CCT
Its action limits Na reabsoprtion in the proximal tubule leading to downstream potassium wasting
acetazolamide
Systemic effects of acetoazolamide
Eye: Decrease HCO3 and lower aqueuous humor production

CSF: acidify CSF to cause hyperventilation and prevent high altitude sickness
Use for glaucoma
acetazolamide
Four toxicities of acetazolamide
Drowsiness and paresthesias
basic urine leads to renal stones
Potassium wasting
hepatic encephalopathy
Four loop diuretics
Furosemide
Bumetanide
torsemide
Ethacrynic acid
Site of action for loop diurectics and duration of action
TAL

Short (4 hours)
Effect of loop diuretics on Na, potassium, calcium and H
Increased Na delivery to the CCT increases K wasting and H secretion...hypokalemic alkalosis

In TAL, inhibition leads to lower K diffuse back to the lumen, and no potential to drive Ca, so Ca excretion goes up
Major use of loop diuretics
Edema in
CHF
Ascites
Acute pulmonary edema
Best diuretic for acute pulmonary edema
Loop diuretics
Treatment of hypercalcemia from malignancy
Loop diuretics
Toxicities of loop diuretics
hypokalemic alkalosis
Severe K wasting (affects heart)
Ototoxicity from reduced excretion of aminoglycosides
Ethacrynic acid differs from other loops in what regards?
It is urocosuric

It also inhibits the basal K-Cl transporter

It is not a sulfanamide derivative
Torsemide vs Furosemide and bumetanide
T acts for 4-6 hours vs 2-3 for F and B
Short actiing thiazide diuretics
Hydrochlorothiazide
Metalozone

2-3 hours
Long acting thiazide diuretics
Chlorthalidone
Indapamide

24-72 hours
Site of action for thiazide diuretics
DCT

Na-Cl transporter
Toxicity of thiazides
hypokalemia
hyperglycemia
hyperuricemia
hyperlipidemia
Increases calcium reabsorption
thiazide diuretics

Hydrocholorthiazide
Metalozone
Indapamide
Chlorthalidone
Uses for thiazides
Hypertension
Chronic edema (eg CHF)
Renal stones from high Ca
Four K sparing diuretics
Amiloride
Triamterene
Spironolactone
Eplerenone
Differences between K sparing diuretics
Amiloride and Triamterene block ENaC

Spironolactone and Eplerenone block aldosterone receptor
Duration of action for Amiloride and triamterence vs. Spironolactone
12-24 vs 27-72
Toxicity of K sparing diuretics
hyperkalemia (don't give w/ K supplement)
gynecomastia
antiandrogenic effects
Side effect of triamterene
poorly soluble and may cause kidney stones
Mannitol
osmotic diuertic

given IV
uses for mannitol
to maintain high urine flow
reduce intraocular pressure
reduce intracranial pressure