Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
50 Cards in this Set
- Front
- Back
Where does acetazolamide work?
|
convoluted proximal tubule
|
|
Where does mannitol work?
|
convoluted proximal tubule
thin descending loop collecting duct |
|
Where does furosemide work?
|
thick ascending limb
|
|
Where do thiazides work?
|
early distal tubule
(maybe straight proximal) |
|
where do aldosterone blockers work?
|
collecting tubule
|
|
Where do ADH agonists work?
|
collecting duct
|
|
Diuretics that work where in the nephron have greatest effect?,
|
earlier
|
|
Why is it that Diuretics that work on the earlier nephron have greatest effect?
|
they are able to block more sodium and chloride reabsorption
|
|
Predominant location of Carbonic Anhydrase enzyme is the ______
|
luminal membrane of the proximal tubule cells
|
|
What major metabolic disturbance might carbonic anhydrase inhibitors cause?
|
metabolic acidosis
|
|
Azetazolamide is Not in use as diuretic anymore.
Primary indications are |
glaucoma
(prevents production of aequous humor) Also: To enhance renal excretion of acidic drugs Metabolic Alkalosis Altitude sickness (decreases cerebral and pulmonary edema) Seizures |
|
Other CA inhibitor:
|
Dorzolamide
|
|
If you're using acetazolamide to treat edema assoc with liver failure, pt may have trouble excreting what?
|
bases, like NH4+
|
|
Pt is allergic to antibiotics. Why not use CA inhibitors?
|
CA-inhibitors are sulfonamides =>cross-allergenic with antibiotics etc.
|
|
Prototype Osmotic Diuretic
|
Mannitol
|
|
Uses of Mannitol
|
Decrease intraocular and intracranial pressure
Prevent anuria in hemolysis and rhabdomyolysis |
|
the sulfonamide-derived loop diuretic
|
Furosemide
|
|
the non-sulfonamide-derived loop diuretic
|
Ethacrynic acid
|
|
the most efficacious diuretic agents available.
|
loops
|
|
Is furosemide diuresis limited be development of acidosis?
|
no
|
|
Normally,
in thick ascending limb, excess cellular K+ leaks into the urine and causes what 2 ions to escape to the interstium thru paracellular pathways. |
Mg2+ and Ca2+
|
|
So, what pharmaceuticals for diuresis can cause hypomagnesemia?
|
loops
|
|
3 of the sulfonamide-derived loop diuretics
|
Furosemide
Bumetanide Torsemide |
|
loop diuretic effects on RAAS.
|
turn RAAS on
|
|
major ion loss side effects of loop diuretics
|
K+
Ca++ Mg++ |
|
Which loop diuretic causes more ototoxicity?
|
ethacrynic acid
|
|
why would ethacrynic acid be given over furosemide?
|
if pt has sulfonamide sensitivity
|
|
loop diuretics = high _____ diuretics
|
ceiling
|
|
Site of action of thiazides
|
Inhibit NaCl transport predominantly in the distal convoluted tubule
|
|
Drug that's not a thiazide but a sulfonamide qualitatively similar to the thiazides
|
Chlorthaladone
|
|
symport blocked by thiazides
|
Na-Cl symport
|
|
Where do thiazides work in relation to the macula densa?
|
after
|
|
Major side effects of thiazides
|
Immediate/Acute Effects; loss of K+ , Na+, Cl- (and Mg++, but not Ca++)
|
|
2 thiazides to know for the test
|
Chlorthalidone*
Hydrochlorothiazide |
|
Chronic effects of Thiazide Diuretics
|
Hyperuricemia
Hyperlipidemia |
|
If you have kidney stones, should you take a thiazide.
|
Sure. It will probably help get rid of your stones.
|
|
Thiazide Diuretic Therapy will have the what effect on Ca, Mg, K, Na electrolytes
|
Calcium Increased
Magnesium Decreased Potassium Decreased Sodium Decreased |
|
Adverse effects of HCTZ
|
Hypercalcemia
Hypokalemia Hypomagnesemia Hyperglycemia Hyperuricemia Pancreatitis Metabolic alkalosis Stevens-Johnson syndrome hyperlipidemia |
|
3 Potassium-sparing agonists
|
Spironolactone
Triamterene Amiloride |
|
Which K-sparers are these?
Inhibition occurs by direct pharmacologic antagonism of mineralcorticoid receptors |
spironolactone, eplerenone
|
|
Which K-sparers are these?
inhibition of Na+ influx thru ion channels in the luminal membrane |
amiloride, triamterene
|
|
Aldosterone receptor is found in the _____
|
basolateral membrane of the principal cell in the collecting duct.
|
|
Adverse Effects of Spironolactone
|
Hyperkalemia
Metabolic acidosis Gynecomastia |
|
2 drugs of choice for treatment of Liddle’s syndrome
|
Triamterene and Amiloride (potassium sparing diuretics)
|
|
What syndrome is this?
Gain of function abnormality of Epithelial Na Channel Results in sodium retention Low levels of aldosterone Formerly known as pseudohyperaldosteronism |
Liddle’s Syndrome
|
|
Amiloride is used to treat
|
HTN
CHF Lithium-induced diabetes insipidus |
|
Diuretic Combinations
|
Loop Diuretics and Thiazides
Potassium-Sparing Diuretics and Loop agents or Thiazides |
|
Treatment of Syndrome of inappropriate ADH secretion (SIADH)
|
Conivaptan
IV injection |
|
Treatment of Nephrogenic Diabetes Insipidus
|
thiazide
|
|
Name of the ADH receptor in the collecting tubule
|
V2
|