Diuretics and RAAS antagonists of HF Flashcards Preview

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Flashcards in Diuretics and RAAS antagonists of HF Deck (40)
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1

Diuretics act on ___ surface

Luminal

2

___ interact with membrane transport proteins

Thiazides, Furosemides, Triamterene

3

___ interact with enzyme and ___ interact with hormone receptors

acetazolamide, apironolactone

4

___ osmotic effect

Mannitol

5

___ is a carbonic anhydrase inhibitor

acetazolamide

6

CA inhibitors causes ____ in ____ (what and where)

decrease NaHCO3 reabsorption
PCT

7

Loop of henle water removal in ___ limb and Na ___ in ___limb

descending
NaCl Reabsorption in accending

8

Na reabsorpted in ascending limb via ______?

NKCC2 (NaK2Cl co transporter

9

Loop diuretics do what?

inhibit NKCC2
Mg/Ca excretion (K intracell high, difuse back to lumen (K channel) drives Mg/Ca reabsorption)
Increase RBF

10

Uses of Loop Diuretics

CHF (volume overload)
Refractory edema (+thiazide, aldosterone antagonists)
Hypercalceimia
Acute Pul Edema

11

HF have ___ diuretic response due to:?

decreased
Decrease drug delivery to kidney, decrease RBF, hypoperfusion activatoin of RAS/SNS

12

Loop diuretic adverse effects

hypokalemic metabolic alkalosis (increase K/H secretion)
Ototoxicity
Hyperuricemia/hyperglycemia
Hypomagnesemia
Hypotension (overdose)

13

Hypokalemia predisposes pt to ___?

ectopic pacemakers/arrhythmias

14

Loop diuretics includes?

Furosemide (most common)
Bumetanide, torsemide (higher F and longer t1/2)

15

DCT is _____ to H2O

impermeable

16

Na is reabsorpted in DCT via ___?

NCC (NaCl co transporter)

17

Ca reabsorption occurs via ___?

Na/Ca exchanger

18

NCX in DCT is regulated by

PTH (Parathyroid hormone)

19

Thiazides inhibits ___

NCC (increase NaCl excretion)

20

Thiazides _______ Ca

increase reabsorption of Ca
(low Na intracellular, activates NCX, decrease Ca intracell, Ca reasborbed from urine)

21

Thiazides drugs include ___?

hydrochlorothiazide (prototype 2x/day)
chlorthalidone/metolazone - longer duration

22

Thiazide adverse efects

Hypokalemia
hyperaldosteronism (volume decrease)
hyperglycemia/glycosuria
Hyperuricemia (precipitate gout attack)
hyperlipidemia (HTN risks)
Allergic - sulfonamide

23

Thiazide acts in ___

DCT

24

Aldosterone acts on __

collecting tubules

25

K excretion is ____ to Na ______ in CT

coupled,
Na reabsorption

26

Aldosterone acts on CT by ____?

gene transcription - increase number/activity of Na/K-atpase

27

Trimaterne, amiloride diuretics acts by ___ at __

direct Na Channel block
CT
(less Na reabsorb = less K excreted

28

Apironolactone/eplerenone act by ____ at __

competitive antagonist at aldosterone receptor
CT
- decrease Na reabsorption, decrease K excretion

29

Uses of potassium sparing diuretics

CHF - aldosterone antag (also at heart)
Hyperaldosteronism
PCOS Hirustism - block androgens
HTN

30

Aldosterone antagonists important actions ____?

anti-remoding (less hypertrophy/fibrosis)
Increase K serum = less arrhythmias