Diuetics

Question 1

What are they

Answer 1

Help reduce fluid buildup in the body and any substance that promotes the increased production of urine

Question 2

What are they used for

Answer 2

Treatment of hypertension but also oedema

Question 3

oedema/

Answer 3

Excessive water in the body

Question 4

How do thy work

Answer 4

Inhibiting the reabsorbtion of ions - Na+ - which gives a higher osmolarty in the kidney tubule and hence more excretion of wtater

Question 5

Classes

Answer 5

Thiazides - bendroflumethozide
Loop - furosemide
K sparing - spironolactone
Carbonic anhydrase - acetazolomide - no longer used
Osmotic - mannitol - not used

Question 6

Proximal tubule

Answer 6

Reabsorbtion of most solutes and water occur here

60-70% of Na and water and 98% glucose reabsorbtion happen in proximal

Most Na is rebsorbed via Na+-H+ exchanger

Question 7

pH regulation

Answer 7

H ions exerted and bicarbonate ions absorbed

Question 8

What acts in the proximal tubule

Answer 8

Carbonic anhydrase inhibitors to have ther diuretic effect

Question 9

Carbonic cnhydrase in proximal

Answer 9

Na move in down its gradient and allows H ions to move up gradient into tubule. Carbonic anhydrase takes water and makes carbonic acid which separates into protons and a bicarbonate which can be transported into blood. These are the H that move out as the Na move in. Na can be pumped out into blood.

Question 10

If no H ions - proximal

Answer 10

Carbonic anhydrase inhibitor will block the carbonic anhydrase so less carbonic acid and less H ions so less Na being reabsorbed. Na remain in tubule and have diuretic effect.

Question 11

Loop of Henle

Answer 11

Water is reabsorbed in descending loop. Na an Cl is reasoned in the ascending loop without water

Loop diuretics act at the ascending loop - inhibit the Na, K, Cl co-transporter

Question 12

Loop diuretics

Answer 12

Low Na in cell.
C1 is a cotransprter taking ions in , from inside the kidney tubule to inside the cell.
Na goes down its gradient and allows other ions to move up their gradients and into cell.
Now Na can now be pumped out again with NaK ATPase.
K can also move out by KCl exchanger with Cl moving into blood.

Diuretic effect = block transporter C1means more Na, more K in the loop tubule, more ion and more water so more urine

Question 13

Lop diuretics and hypokalaemia

Answer 13

They lower blood pressure by helping the body pass sodium and water through the urine. Some diuretics also cause the body to pass more potassium in the urine. This can lead to low potassium levels in the bloodstream, also called hypokalemia.

Question 14

Distal tubule

Answer 14

Na and Cl are reabsorbed here without water

Thiazides diuretics work here inhibiting Na, Cl, cotranspoerter/symporter

Question 15

Thiazides diuretics

Question 16

Collecting duct

Answer 16

Water is reabsorbed under the contro of ADH and aldosterone
K-sparing diuretics work here inhibiting epithelial Na channel

Question 17

K-sparing diuetics

Question 18

Bendroflumethazide vs amiloride

Answer 18

Amiloride is a medication used in the management and treatment of hypertension and heart failure. It is a diuretic.

Bendroflumethiazide is also a diuretic. It’s used to treat hypertension and oedema.

Different diuretics can be taken together

Both work in kidney tubule just different places (bendro = distal, and amiloride = collecting duct)

Both increase urine output and Na in urine, therefore increase water etc as are diuretics

Both work at membrane transport systems