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29 Cards in this Set
- Front
- Back
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Nephrons
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functional units found in the renal cortex |
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Renal corpuscle
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Filter unit with glomerulus and glomerular capsule
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Renal tubule
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Proximal convoluted tubule, loop of Henle and distal convoluted tubule
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How does urine production promote homeostasis?
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By regulation of blood volume and composition
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Name the 3 organic waste products
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Urea- most abundant waste
creatinine- produced in skeletal muscle tissue Uric acid- formed by recycling nitrogenous bases from RNA molecules |
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How is electrolyte and fluid balance maintained?
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glomerular filtration--> tubular secretion--> tubular reabsorption--> Urinary excretion
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Diuresis in elderly people
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Decreased ability to concentrate urine
decreased ability to tolerate dehydration or water loads fewer nephrons reduced drug elimantion more drug accumulation in plasma- higher possibility of toxicity |
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What are the general features of Diuretics?
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Promote water loss from body into urine
remove excess extracellular fluid into interstitial fluid which would otherwise result in edema |
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What is the mechanism of Thiazide?
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In the cortex- inhibit active exchange of Cl-Na in the cortical diluting segment of the ascending loop of Henle.
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What is the mechanism of potassium sparing agents in the Medulla?
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Inhibits the reabsorption of Na in the distal convoluted and collecting tubule.
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What is the mechanism of Loop diuretics in the Medulla?
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Inhibit the exchange of Cl-Na-K in the thick segment of the ascending loop of Henle
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Thiazide Diuretics role?
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Inhibit Na reabsorption. Increases excretion of Cl, K and biocarbonate ions
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What are thiazide diuretics used to treat?
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Patients with hypertension
As adjunctive therapy in Oedema associated with heart failure and cirrhosis |
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What are the adverse reactions of Thiazides?
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Anorexia, Gastric irritation, nausea, vomiting, cramping, diarrhoea, constipation, jaundice, hypokalemia and pancreatitis.
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What are the serious adverse reactions associated with Thiazide?
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anaphylactic reactions, respiratory distress
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What are the contraindications of Thiazide
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patients with diabetes, history of gout, severe renal disease and impaired renal function.
elderly patients not recommended while lactating contraindications with corticosteriods, lithium, probenecid and anti diabetic agents |
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How do Loop diuretics work?
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They act on the loop of henle to inhibit sodium and chloride reabsorption.
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What type of diuretic drug is the drug of choice when treating acute pulmonary edema of heart failure, hypercalcemia and hypertension?
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Loop Diuretics
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common: Fluid/electrolyte imbalances, skin rashes, photosensitivity and Hypotension
Serious: Circulatory collapse, thromboemboli, hepatic encaphalopathy, ototoxicity, shock, cardiac arrythmias, bone marrow arrythmias |
Adverse reactions of Loop Diuretics
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What are the contraindications of Loop Diuretics?
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Not advised for patients who are lactating.
Avoid in patients with severe diarrhoea, dehydration, electrolyte imbalance or hypotension. They interact with NSAIDs, lithium, anticoagulants, aminoglycosides and thiazide diuretics. |
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How do potassium sparing agents work?
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Prevents sodium reabsorption in the distal tubule.
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What are potassium sparing agents used to treat?
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Edema of heart failure, hepatic cirrhosis with ascites and nephrotic syndrome. Used mainly in combination with drugs to treat hypertension
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Common: Kidney Stones, gynecomastia
Serious: Life-threatening hyperkalemia, renal failure |
The adverse effects of potassium sparing agents
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Contraindicated in patients with acute renal insufficiency, impaired renal function or hyperkalemia
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Contraindications of potassium sparing agents
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E.g. Mannitol and Glycerin
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Examples of Osmotic diuretics
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Decreasing solute content resulting in less water reabsorption by loop of Henle and collecting duct.
Less sodium reabsorption in proximal tubule. |
How to osmotic diuretics work?
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What are osmotic diuretics used to treat?
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cerebral edema
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Common: Headache, tremor/convulsions, dizziness, hypo/hypertension, thrombophlebitis, blurred vision, dry mouth, nausea/vomiting.
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Adverse effects of osmotic diuretics
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contraindications of osmotic diuretics
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Anuria, pulmonary congestion or severe edema congestive heart failure, metabolic edema, intracranial bleeding, shock, severe dehydration, pregnancy and lactation.
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