2B : DIURETICS Flashcards
(68 cards)
1
Q
Baroreceptor is located in
A
carotid
sinus and aorta
2
Q
Primary autonomic
mechanism for
blood pressure
homeostasis
A
Baroreceptor Reflex
3
Q
involves sensory input from carotid
sinus and aorta to the vasomotor
center and output via PSNS and SNS
A
Baroreceptor Reflex
4
Q
The most important DIURETICS for treating
hypertension are the
A
- THIAZIDES
- LOOP DIURETICS
5
Q
for mild and moderate HPN
A
Thiazide
6
Q
for severe HPN and HPN
emergencies
A
Loop
7
Q
5 classes of diuretics
A
- CARBONIC ANHYDRASE INHIBITOR
- LOOP DIURETICS
- THIAZIDES
- K+ SPARRING DIURETICS
- OSMOTIC DIURETIC
8
Q
diuretics acting on PROXIMAL convuluted tubules
A
CARBONIC ANHYDRASE INHIBITOR
ex., acetazolamide
proksimal=karbonik
9
Q
diuretics acting on THICK ASCENDING LIMB
A
loop diuretics
ex., furosemide
10
Q
acting on distal convuluted tubule
A
thiazides
11
Q
acting on CORTICAL COLLECTING TUBULES
A
potassium sparring diuretics
12
Q
drugs that modify SALT EXCRETION
A
- CARBONIC ANHYDRASE INHIBITOR
- LOOP DIURETICS
- THIAZIDES
- K+ SPARRING DIURETICS
- OSMOTIC DIURETIC
13
Q
Drugs that modify WATER EXCRETION
A
- ADH agonists (desmopressin)
- ADH antagonist (conivaptan)
14
Q
- Filters large quantities of plasma
- Reabsorbs substances the body conserve
- Leave behind and/or secrete substances that must be eliminated
A
KIDNEY
15
Q
Structural and Functional
Unit of the kidneys
A
NEPHRON
16
Q
There are two major
TYPES
of nephrons:
A
- CORTICAL NEPHRON
- JUXTAMEDULLARY
17
Q
- 75% of nephrons
- Located in the renal cortex
- With shorter loops of henle
- Has peritubular capillaries
A
CORTICAL NEPHRON
18
Q
- **25% **of nephrons
- located in the corticomedullary junction
- with longer loops of henle
- Has vasa recta
A
JUXTAMEDULLARY
19
Q
There are two major
PARTS
of nephrons:
A
- RENAL or MALPIGHIAN
CORPUSCLE - RENAL TUBULES
20
Q
- Afferent & Efferent arterioles,
- Glomerular capillaries,
- Podocytes,
- Mesangial cells,
- JG cells,
- Bowman’s capsule
A
RENAL or MALPIGHIAN
CORPUSCLE
21
Q
Parts of Renal tubules
A
PCT- Proximal Convoluted Tubule
LH - Loop of Henle
DT - Distal Tubule
CD - Collecting Duct
22
Q
parts of Loop of Henle
A
- Descending LOH
- Thin Ascending LOH
- Thick Ascending LOH
23
Q
parts of distal tubule
A
- First part: Early Distal Tubule
- Second part: Late Distal Tubule/Connecting
tubule,** cortical collecting tubule**
24
Q
part of collecting duct
A
- Medullary Collecting Tubule
- Collecting Duct
25
Workhorse
of the nephron
Proximal Convoluted Tubule
26
transporter that reabsorbps 100 %
of filtered glucose, amino acids
(isosmotic)
SGLT2 cotransporter
27
what is being secreted in proximal convoluted tubule
Excess acids
28
it has
* (+) microvilli and convolutions
* where Isosmotic fluid reabsorption (from lumen to capillaries) happens
* ***Most susceptible to toxins***
Proximal Convoluted Tubule
29
what are being **reabsorb** in **early PCT**
Site for reabsorption of **Na**,
**H20**, **HC03** and **glucose**
1. Na
2. H20
3. HCO3
4. Glucose
30
histology of PCT
1. **Simple cuboidal** or **Columnar epithelial cells**
2. Long microvilli
3. cytoplasm is **more eosinophilic** than distal convoluted tubules and collecting duct
31
**descending** limb of loop of henle is **permeable to**
water
| **DE**SCENDING-Permeable to **WA**TER
32
descending limb of loop of henle is *impermeable to*
solutes
33
**ascending limb** of loop of henle is **permeable**
**solutes**
| **AS**CENDING-permeable to **SO**LUTES
34
**ascending limb** of loop of henle is *impermeable to*
water
35
* Also called
diluting segment
* where can you find **N-K-2CL symport**
Ascending limb
36
* Also called **“cortical
diluting segment”**
* Site of
**Macula Densa**
Early Distal Tubule (EDT)
37
two type of cell in Late Distal Tubule (LDT)
1. principal cells
2. intercalated cells
38
Site of action of
Aldosterone
Late Distal Tubule (LDT)
| in aldosterone you can form the world LATE; dos=distal t=tubule
39
Reabsorb: **Na+ and
water**
Secrete: **K+**
Principal cells
40
**Reabsorb: K+**
Secrete: **H+**
Intercalated cells
41
Site of ADH** (antidiuretic hormone)**
action
Collecting Duct
42
mechanism of AdH
* Increase ADH -->
increase
**aquaporin 2
channels** -->
increase
**reabsorption**
43
transporter for amino acids, nucleosides, sugars
uniporter (one molecule)
44
transporter which movement is in the same direction like Na+/glucose co transporter in the intestine
Symporter/cotransporter
45
type of transporter of Cl-/HCO3- exchanger in the red blood cell
antiporter/exchanger
46
**reabsorption** of **water**, ions and all **organic nutrients**
proximal convoluted tubule
47
**secretion** of ACIDS, DRUGS TOXINS
variable reabsorption of water, sodium ions, and calcium ions (under hormonal control)
distal convoluted tubule
48
variable reabsorption of water and absorption or secretion of sodium, potassium, hydrogen and bicarbonate ions
connecting tubules and collecting duct
49
delivery of urine to minor calyx
papillary duct
50
further reabsorption of water (descending limb) and both sodium and chloride ions (ascending limb)
loop of henle
51
production of filtrate
renal corpuscle
52
movement from
**Glomerular capillaries to Bowman’s space**
Glomerular Filtration
53
Glomerular Filtrates
volume & composition is
altered by:
1. Tubular reabsorption
2. Tubular secretion
54
movement from** tubules**
**to interstitium** to peritubular capillaries
Tubular reabsorption
55
movement **from** peritubular
**capillaries** to interstitium to **tubules****
Tubular secretion
56
measurement of the excretion and plasma level of a substance that is freely filtered
GFR
57
excretion =
Filtration - reabsorption + secretion
58
mechanism of diuretics action
1.** inhibit enzymes**
2. exert effects on **specific membrane transport in tubular
epithelial cells**
3. **decrease rate of Na+
reabsorption** from the tubules
4. exert **osmotic effects**
5. interfere with **hormone receptors**
59
Principles of Diuretic Action
1. Increase urine flow
2. Increase excretion of Na+ & an accompanying anion
(usually Cl)
3. Most clinical applications of Diuretics: reduction of ECF
fluid volume by decreasing total body NaCl content
4. Modify renal handling of other
cations , anions, uric acid
5. May indirectly alter renal
hemodynamics
60
Natriuresis
is Finite because
renal compensatory
mechanisms bring Na+ excretion in line with Na+ intake
61
Braking & Compensatory mechanisms:
ANS activation, RAAS activation, ↓ aBP , renal epithelial cell hypertrophy, increased expression
of renal epithelial transporters, alterations in natriuretic hormones
62
drugs under Carbonic
Anhydrase
inhibitor
**Acetazolamide**
Dorzolamide
Brinzolamine
Dichlorphenamide
Methazolamine
63
drugs acting on Thick ascending limb of loop of henle
**LOOP DIURETICS**
**Furosemide**
Bumetanide
Torsemide
Ethacryanic ACID
64
DRUGS UNDER THIAZIDE DIURETICS
**Hydrochlorothiazide**
Chlorthalidone
Indapamide
Metolazone
Bendroflumethiazide
Polythiazide
65
Potassium Sparing
Diuretics drugs
**Spironolactone**
Eplerenone
**Amiloride**
Triamterene
66
MR Antagonists
**Spironolactone**
Eplerenone
67
ENaC inhibitor
**Amiloride**
Triamterene
68
drugs under Osmotic
Diuretic
**Mannitol**
Glycerin
Isosorbide
Urea
