Flashcards in Diuretics Deck (32):
Describe sodium reabsorption at the PCT
Na+/K+ ATPase brought sodium into the interstitium.
Na+/H+ exchanger brought sodium into the intracellular compartment from the tubular lumen.
Role of Carbonic Anhydrase
CA associates H+ with CO2 to form Carbonic Acid. Carbonic acid diffuses into the intracellular compartment where CA again converts Carbonic acid to CO2 and H2O. H2O is then reabsorbed into the interstitium along with the other solutes.
CA finally converts H2O and CO2 into H+ and HCO3-.
Name the CA-inhibitor
Inhibits carbonic anhydrase. HCO3-1 and Na+ remain in the tubular lumen. Water is also unable to be reabsorbed.
Does Acetazolamide cause metabolic acidosis or alkalosis?
Acidosis b/c HCO3- is unable to be reabsorbed.
Decreases intraoccular pressure
Decreases production of CSF.
Prevent mountain sickness.
Acetazolamide adverse effects
Type II renal tubular acidosis
Calcium phosphate stones.
Decreases intracranial and intraocular pressure
Mannitol adverse effects.
Expanded extracellular volume causing pulmonary edema.
Exacerbate heart failure
Explain reabsorption at the Loop of Henle
Na+/K+ ATPase reabsorbs sodium into the interstitium.
The Na/K/2Cl transporter brings these ions into the intracellular compartment.
Is the the ascending limb of the loop of Henle permeable to water?
No, this segment is called the diluting segment.
Name the loop diuretics
Inhibits the N/K/Cl co-transporter
Loop diuretics promote the excretion of what ions and why?
Mg and Ca
These are excreted because diuretics lower the positive charge w/in the tubular lumen
Connection b/w loop diuretics and prostaglandins?
Induce the expression of COX-2 thereby increasing production of prostaglandins.
Prostaglandins dilate the afferent arteriole and cause an increased excretion of salt.
Loop diuretics treatment?
1st line for acute symptomatic HF
Loop diuretics adverse effects?
Reabsorption at the DCT
Na/K ATPase drive sodium into the interstitium.
Na/Cl co-transporter drives these ions into the intracellular compartment.
PTH regulates the active reabsorption of calcium at the DCT
Name Thiazide diuretics
Thiazide diuretics MOA
Inhibit the NCC and promote the excretion of sodium and chloride.
Enhanced reabsorption of Ca++
Symptomatic treatment of HF
Nephrogenic diabetes insipidus
Prevent calcium stones
Thiazide adverse effects
Name the K+ sparing diuretics
Reabsorption at the collecting duct
Aldosterone exerts its effects here.
Contains principal cells.
Na/K ATPase brings sodium into the interstitium.
ENaC reabsorbs Na+ from the tubular lumen.
K+ is excreted
Alpha-intercalated cells excrete H+ via the H+ ATPase
Inhibit ENaC, thus inhibiting reabsorption of Na+
Mineralocorticoid receptor antagonist, thus inhibiting the effects of Aldosterone
Mineralocorticoid receptor antagonist
Eplerenone and Spirinolactone treatment
1* or 2* Hyperaldosteronism
K+ Sparing diuretics treatment
Prevent myocardial remodeling