Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Renal > Drugs acting on the kidneys > Flashcards

Drugs acting on the kidneys Flashcards

(75 cards)

Start Studying
1
Q

What are diuretics?

A

agents that increase urine output through causing a net electrolyte and water loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do the organic anion transporters transport?

A

acidic drugs eg thiazides and loop agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What do organic canion transporters tranposrt?

A

basic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where do loo/p diuretics work

A

ascending loop of Henle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What transporter do loop diuretics inhibit?

A

Na/K/2Cl cotransporter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where do thiazides work?

A

DCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where does spironolactone work?

A

collecting duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why do loop diuretics cause hypokalaemia?

A

increase the load of sodium to DCT which results in compensatory mechanisms to get sodium back in exchange for potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What other electrolyes are depleted with looop diuretics?

A

calcium and magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What action do loop diuretics have on blood vessels?

A

venodilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What acid-base abnormality can be cause by loop diuretics?

A

metabolic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the adverse effects of loop diuretics?

A

hypokalaemia; hypomagnesaemia; hypocalcaemia; hyperglycaemia; hyperuricaemia; hearing loss; hypovolaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why do loop diuretics cause hearing loss?

A

there are the same cotranporters in endolymph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What transporter do thiazides work on?

A

bind to Na/Cl symprter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What effect do thiazides have on calcium?

A

increase reabsorption of calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why are thiazides not as potent as loops?

A

because by DCT lots of sodium has already been reabsorbed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What effect do thiazides have on vessels?

A

vasodilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the uses of thiazides?

A

mild HF; HT; nephrolithiasis (hypercalciuria); nephrogenic DI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Are thiazides and loops effective in renal failure?

A

loops are, thiazides arent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What extrarenal metabolic disturbances do thiazides cause?

A

hyperglycaemia and hyperlipidaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the side effects of thiazides?

A

postural hypotension; metabolic alkalosis; hypokalaemia; hyponatraemia; hypomagnesaemia; hypercalcaemia; hyperuricaemia; low blood counts; impotence; pancreatitis; cholestasis; pneumonitis; photosensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does risk of hypokalaemia depend on?

A

duration of action of the drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which type of diuretic is less likely to cause hypokalaemia?

A

loop- shorter duration of action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Waht are teh signs of hypokalaemia?

A

weaknss; myalgia, fatigue, arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How do loop diuretics cause metabolic alkalosis?
The increased sodium at the DCT causes the DCT to increase sodium reabsorption using Na/H transports and Na/K transports leading to hypokalaemia and alkalsis, the loss of chloride also leads to loss of anions so body gets more bicarb to replace
26
What is the main problem associated with loop and thiazides?
cause secondary hyperaldosteronism
27
What is the use of potassium sparing diuretics?
although weak diuretics on their own they blunt the secondary hyperaldosteronism with other diuretics so are useful in adjucts
28
What is the action of amiloride and triamterene?
block the apical sodium channel to decrease sodium reabsorption
29
What is the action of spironolactone and eplerone?
compete with aldosterone
30
What type of receptor does spironolactone compete with aldosterone for?
intracellular receptors
31
What does the competitive antagonism of spironolactone cause?
decreased gene expression and reduced synthesis of a protein mediator that activates sodium channels in the apical membrane and decrease the numebrs of sodium potassium pumps in the basolateral membrane
32
How do amiloride and triamteren enter the nephron?
via organic cation tranport system in the PT- basic drugs
33
What is the active metabolite of spironolactone?
canrenone
34
What is the difference between amiloride and traimterene?
although amilordie is 10x more potent, triamterene is better absorbed fro mthe GI tract
35
What hormonal disturbances does spironolactone cause?
gynaecomastia, impotence and menstrual irregularities
36
When are there increased risk of hyperkalaemia assocaited with sprionolactone?
with used with potassium suppements and ACEi/ARBs
37
Where is the carbonic anhydrase enzyme present?
renal tubules; gastric mucosa; pancreas, eye, brain and RBCs
38
What is the actions of CA inhibitiors?
increase excretion of bicarbonate with sodium, potassium and water
39
What can CAi result in?
alkaline diuresis; hypokalarmia and metabolic acidosis
40
What are carbonic anhydrase inhibitors used for?
glaucoma; acute mountain sickness;
41
What is the name of osmotic diuretics?
mannitol
42
What is the major site of action in the kidneys of mannitol?
proximal tubule
43
How is mannitol given?
IV
44
How does mannitol get into the tubule?
freely filtered at the glomerulus
45
What are the pharmacology properties of mannitol?
pharmacologically inert; not metabolised in the body; does not enter cells
46
What are osmotic diuretics used for?
raised ICP and IOP; prevention of impending acute renal failure
47
What type of receptor does ADH work on?
GPCR
48
What do V1 receptors do?
vasconstriction
49
What do V2 receptors do?
vasodilatory; increase water reaborption in renal CD
50
What are aquaretics/vaptans?
competitive antagonsits of vasopressin receptors
51
What do vasopressin receptor antagonists cause?
electrolyte free aquaresis; reduce urine osmolality; raise seum Na
52
What is the main SE of osmotic diuretics?
hyponatraemic headache
53
What is the main SE of aquaretics/ vaptans?
increased thirst
54
What is the MOA of mannitol?
The presence of a nonreabsorbable solute such as mannitol prevents the normal absorption of water by interposing a countervailing osmotic force. As a result, urine volume increases. The increase in urine flow rate decreases the contact time between fluid and the tubular epithelium, thus reducing sodium as well as water reabsorption.
55
How are prostaglandins formed?
from the fatty acid arachidonic acid in membrane phospholipids by the COX enzymes
56
Which COX enzyme is mainly active during inflammation?
COX2
57
What are hte PGs important in the kidneys?
PGE2 and PGI2
58
What is the function of PGs in the kidney?
they are vasodilators and so increased renal blood flow and eGFR; increase water, Na and K excretion
59
When are PGs most important?
in angiotensin induced vasoconstriction in volume deleted states
60
When is renal blood flow dependent upon vasodilator prostaglandins?
CHF; cirrhosis and nephrotic syndrome
61
What is the effect of NSAIDs?
tend to retain salt and water by inhibiting COX and PG synthesis
62
What is the triple combination of drugs that can cause serious renal problems?
ACEi + diuretic + NSAID
63
What is the difference between the action of uricosuric agents vs allopurinol?
allopurinol inhibits urate synthessis whereas uricosuric drugs reduce reabsorption of urate
64
How do uricosuric agents reduce reabsorption of urate?
block the active transport of organic acids
65
Who are uricosuric agents unsuitable for use in?
patients with renal impairment of hx of renal stones
66
Why must high doses of uricosuric agents be given rather than low dose?
at low dose, uricosuric agents block urate secretion- increasing blood urate levels
67
Give examples of uricosuric agents?
probenecid; sulfinpyrazole
68
What uricosuric agent may be used in mild renal impairment?
benzbromarone
69
What other drugs have mild uricosuric properties?
losartan and fenofibrate
70
What should patients be told to do when started on a uricosuric agent?
increase fluid intake to 2-3 litres daily
71
What drugs antagonise uricosuric drugs in the proximal ubule?
aspirin and other salicylates
72
Gvie examples of SGLT2 inhibitors?
dapaglilofzin and empagliflozin
73
What drugs cause uricaemia?
thiazides and loops
74
How do SGLT work?
transport glucose against a conc gradient by coupling it to sodium influx
75
What are the effects of SGLT2 inhibitors?
excretion of glucose, decrease in HbA1c and weight loss (calorific loss and mild osmotic diuresis); increased genital infections

Renal (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions