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Cardiovascular, Renal and Peripheral Pharmacology > Kidney and Diuretics > Flashcards

Kidney and Diuretics Flashcards

1
Q

3 functions of the kidney

A
  • regulate extracellular body fluid volume
  • maintain ion/pH balance in plasma
  • excretion of foreign substances
  • renin secretion
  • activation of RAAS
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2
Q

5 groups of diuretics

A
  1. Carbonic Anhydrase Inhibitors
  2. Osmotic Diuretics
  3. Loop Diuretics
  4. Thiazides and Thiazine-Like Diuretics
  5. Potassium-sparing Diuretics
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3
Q

Name a carbonic anhydrase inhibitor

A

acetazolamide

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4
Q

effects of CAIs

A 
moderate decrease in Na+ absorption
mild plasma acidosis (due to H+ retention)
urine alkalosis (due to bicarbonate secretion)
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5
Q

why is urine alkalosis good

A

increases the excretion of weak acids, so decreases the chance of crystallisation

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6
Q

what else can CAIs be used to treat

A

Glaucoma, as it decreases formation of AH)

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7
Q

where do CAIs predominantly work

A

proximal tubule

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8
Q

Example of a osmotic diuretic

A

mannitol

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9
Q

where do osmotic diuretics work

A

PCT, Descending Loop, Collecting Tubule (parts of the nephron which are freely permeable to water)

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10
Q

are these osmotic diuretics used often?

A

no

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11
Q

how do osmotic diuretics work?

A

increase the osmolarity of the tubular filtrate, so decreases water reabsorption

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12
Q

what else can osmotic diuretics be used in

A

cerebral oedema and glaucoma

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13
Q

most powerful group of diuretics

A

loop diuretics

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14
Q

2 examples of Loop Diuretics

A

furosemide and bumetanide

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15
Q

what symporter do loop diuretics work on

A

Na+/K+/2Cl- on luminal membrane

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16
Q

what effect do these have on the Na/K/2Cl symporter

A

inhibit reabsorption of these ions

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17
Q

another effect of loop diuretics

A

inhibit Mg/Ca reabsorption

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18
Q

Renal effects caused by Loop Diuretics

A

decreased Na reabsorption
decreased Cl reabsorption
increased K excretion
increased Ca and Mg secretion

19
Q

therapeutics of Loop Diuretics

A

acute pulmonary oedema
chronic heart failure
renal failure
nephrotic syndrome

20
Q

what is a side effect of Loop Diuretics

A

hypokalaemia (due to increased K excretion)

21
Q

name 2 thiazides

A

hydrochlorothiazide and Bendroflumethiazide

22
Q

name 3 thiazide-like diuretics

A

chlortalidone, indapamide, metolazone

23
Q

where do thiazides/thiazide-like diuretics work

A

inhibit Na/Cl cotransporter

24
Q

side effect of thiazides/thiazide-like diuretics

A

hypokalaemia

25
Q

renal effects of thiazides/thiazide-like diuretics

A

decreased Na reabsorption
decreased Cl reabsorption
increased K excretion
increased Ca reabsorption

26
Q

are these thiazides/thiazide-like diuretics strong?

A

moderate

27
Q

after prolonged use what other effect can thiazides/thiazide-like diuretics have

A

vasodilating properties

28
Q

how can thiazides/thiazide-like diuretics be used therapeutically

A

hypertension
mild heart failure
sever resistant oedema
prevention of kidney stone formation

29
Q

adverse effects of thiazides/thiazide-like diuretics

A

hypotension, reduced plasma volume, hypokalaemia

30
Q

what are 3 effects of hypokalaemia

A

tachyarrhythmias, hyperglycaemia, increased cardiac toxicity

31
Q

how to potassium-sparing diuretics work

A

inhibit the effect of aldosterone

32
Q

are potassium-sparing diuretics strong?

A

nope

33
Q

how does aldosterone work?

A

increase synthesis of basolateral Na/K ATPase

increases activation and surface expression of luminal renal Na channels

34
Q

what aldosterone would usually help do

A

Na taken in from lumen, then exported into the blood in exchange for a K, so K taken out of the blood (so normally result in hypokalaemia)

35
Q

what are the 2 groups of potassium-sparing diuretics

A
  1. Mineralocorticoid (aldosterone) Receptor Antagonists (MRAs)
  2. Renal Na+ channel blockers
36
Q

2 examples of MRAs

A

spironolactone and eplerenone

37
Q

2 examples of renal Na+ channel blockers

A

amiloride and triamterene

38
Q

the whole point of potassium-sparing diuretics

A

to block the effect of 2 receptors, so K stays in the blood

39
Q

therapeutic uses of potassium-sparing diuretics

A

hypokalaemia, heart failure, treat aldosteronisms

40
Q

adverse effect of potassium-sparing diuretics

A

hyperkalaemia

41
Q

where do potassium-sparing diuretics

A

distal convoluted tubule

42
Q

where does most water reabsorption happen

A

collecting duct

43
Q

what increases the expression of Aqua-porin 2 on the luminal membrane

A

ADH

44
Q

expression of Aqua-poring causes

A

increased water reabsorption
less pee/urine
decreases diuresis

Cardiovascular, Renal and Peripheral Pharmacology (13 decks)

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