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33 Cards in this Set
- Front
- Back
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Major site of bicarbonate reabsorption
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Promixmal convoluted tubule
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Segment with Na, K, 2Cl cotransporter
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Thick ascending limb
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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?
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Creates positive potential to drive Ca and Mg reabsporption.
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PTH controlls the Ca reabsorption in what segment?
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Distal convoluted tubule
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This diuretic is an exception in that it enters cell from the basolateral side instead of being filter or secreted
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Spironolactone
binds to the aldosterone receptor and antagonizes its effects |
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Site of action for acetazolamide
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Proximal tubule
a brush border and intracellular carbonic anhydrase inhibitor |
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Acetazolamides effects on sodium and potassium
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CA produces less H to countertransport with Na, so Na excretion goes up and thusly, so does K when it reaces the CCT
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Its action limits Na reabsoprtion in the proximal tubule leading to downstream potassium wasting
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acetazolamide
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Systemic effects of acetoazolamide
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Eye: Decrease HCO3 and lower aqueuous humor production
CSF: acidify CSF to cause hyperventilation and prevent high altitude sickness |
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Use for glaucoma
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acetazolamide
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Four toxicities of acetazolamide
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Drowsiness and paresthesias
basic urine leads to renal stones Potassium wasting hepatic encephalopathy |
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Four loop diuretics
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Furosemide
Bumetanide torsemide Ethacrynic acid |
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Site of action for loop diurectics and duration of action
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TAL
Short (4 hours) |
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Effect of loop diuretics on Na, potassium, calcium and H
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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 |
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Major use of loop diuretics
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Edema in
CHF Ascites Acute pulmonary edema |
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Best diuretic for acute pulmonary edema
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Loop diuretics
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Treatment of hypercalcemia from malignancy
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Loop diuretics
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Toxicities of loop diuretics
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hypokalemic alkalosis
Severe K wasting (affects heart) Ototoxicity from reduced excretion of aminoglycosides |
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Ethacrynic acid differs from other loops in what regards?
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It is urocosuric
It also inhibits the basal K-Cl transporter It is not a sulfanamide derivative |
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Torsemide vs Furosemide and bumetanide
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T acts for 4-6 hours vs 2-3 for F and B
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Short actiing thiazide diuretics
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Hydrochlorothiazide
Metalozone 2-3 hours |
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Long acting thiazide diuretics
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Chlorthalidone
Indapamide 24-72 hours |
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Site of action for thiazide diuretics
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DCT
Na-Cl transporter |
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Toxicity of thiazides
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hypokalemia
hyperglycemia hyperuricemia hyperlipidemia |
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Increases calcium reabsorption
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thiazide diuretics
Hydrocholorthiazide Metalozone Indapamide Chlorthalidone |
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Uses for thiazides
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Hypertension
Chronic edema (eg CHF) Renal stones from high Ca |
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Four K sparing diuretics
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Amiloride
Triamterene Spironolactone Eplerenone |
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Differences between K sparing diuretics
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Amiloride and Triamterene block ENaC
Spironolactone and Eplerenone block aldosterone receptor |
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Duration of action for Amiloride and triamterence vs. Spironolactone
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12-24 vs 27-72
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Toxicity of K sparing diuretics
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hyperkalemia (don't give w/ K supplement)
gynecomastia antiandrogenic effects |
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Side effect of triamterene
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poorly soluble and may cause kidney stones
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Mannitol
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osmotic diuertic
given IV |
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uses for mannitol
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to maintain high urine flow
reduce intraocular pressure reduce intracranial pressure |
