32 - Renal drugs Pt. 3 Flashcards Preview

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Flashcards in 32 - Renal drugs Pt. 3 Deck (20):
1

Most common Renal Na channel (ENaC) blocker?

amiloride

2

Renal Na channel blockers act where?

distal convoluted tubule

3

Renal Na channel is luminal or basolateral?

luminal. the K channel is basolateral, and retains K in blood when Na channel is blocked (no electric gradient created on luminal side)

4

For renal Na channels blockers, most ion excretions go down or up? what are the exceptions?

-Down
-Na & Cl go up
-HCO3, N2PO4, uric acid unaffected

5

which na channel blocker has long half life for clinical use?

amiloride

6

Treat Liddle's syndrome w/ what diuretics?

renal Na channel blockers

7

5% afrincan americans have a polymorphism that makes which diuretics extra potent?

ENaC

8

which ENaC blocker (Renal Na channel blocker) is also a folate antagonist?

Triamterene

9

mineralocorticoid antagonists have what mech?

block mineralocorticoid receptor (stop Na reabsorption only).

10

mineralocorticoids are almost the same as what class?

ENaC blockers

11

How are mineralocorticoids different from ENaC blockers?

-Don't have to enter tubular lumen to work
-mech
-Rest is same

12

How do mineralocorticoids normally act?

In nucleus: up transcription of AIP (aldosterone-induced proteins). These activate previously silent Na channels & pumps.

13

which mineralocorticoid antag has possible malignancies from chronic use?

spironolactone

14

which mineralocorticoid antag is treatment for primary and secondary hyperaldosteronism, and for ascites/edema from cirrhosis?

spironolactone

15

Which has more systemic effects? V1 or V2?

V1. [that's why we use desmopressin, not vasopressin as antidiuretic]

16

How do V1 receptors work?

down renal blood flow-> up salt gradient

17

How do V2 receptors work? (3)

H2O reabsorption up in distal tubule & collecting duct in 3 ways:
-up aquaporins
-up permeability to urea
-up Na/K/2Cl symporter activity

18

Xanthine oxidase (inhibited by allopurinol) normally does what?

converts xanthine to urate

19

probenecid inhibits excretion of other diuretic drugs. this means the diuretics will work better or worse?

WORSE! have to get to lumen to work.

20

what's probenecid's biphasic effect on gout?

-stoops urate excretion first...
-then prevents its reabsorption.