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Flashcards in Easy pharmacology Deck (38)
1

Which carrier do loop diuretics inhibit and which ion bit do they bind to?

Na+/K+/2Cl-

Bind to chlorine

2

Which other ions are excreted when you use loop diuretics?

Ca 2+ and Mg 2+

3

Additional effects of loop diuretics?

Venodilator
-beneficial in pulmonary oedema caused by heart failure

4

Which transporter do thiazide diuretics block?

The Na+/Cl-
(bind to the Cl- site)

5

Thiazide diuretics, calcium and magnesium

Inhibit secretion of calcium (i.e. less will be excreted)
Increase excretion of magnesium

6

Additional effects of thiazide diuretics

Vasodilator (can be used in hypertension)

7

Type of diuretic used in renal stone disease?

Thiazide
(reduced excretion of calcium discourages stone formation)

8

Type of diuretic used in nephrogenic diabetes?

Thiazide diuretic, mechanism poorly understood

9

Diuretics associated with male sexual dysfunction?

Thiazide diuretics

10

Diuretics associated with impaired glucose tolerance?

Thiazide diuretics

11

Aldosterone and the Na+/K+ATPase?

Aldosterone increases synthesis of the Na+/K+ATPase

12

What is ENaC?

Epithelial Na+ channel

13

Which hormone increases production of ENaC?

Aldosterone

14

ADH and aquaporins (H20 channels) in the cell membrane?

ADH increases the number of these channels

15

Why do loop and thiazide diuretics cause potassium loss?

There is an increased Na+ load in the tubule because loop/thiazide diuretic prevented its reabsorption earlier

--> increased Na+ reabsorption -->

Membrane becomes depolarised -->

K+ and H+ are secreted

16

Which channel do Amiloride and Triamterene block?

Block the apical Na channel and decrease Na reabsorption

17

How do spironolactone and eplerenone work?

Compete with aldosterone for binding to intracellular receptors (cytoplasmic receptors)

-cause decreased synthesis of protein which activates Na+ channel

-decreased numbers of Na+/K+ ATPase pumps in the basolateral membrane

18

Canrenone?

Spironolactone is metabolised to canrenone which accounts for most of the action of the drug

19

How are spironolactone and eplerenone absorbed?

Absorbed from the GI tract

20

Triamterene and Amiloride and GI absorption?

Triamterene is absorbed well
Absorption of amiloride is poor

21

...used in the treatment of:

Heart failure
Primary hyperaldosteronism (Conn’s syndrome)
Resistant essential hypertension
Secondary hyperaldosteronism (due to hepatic cirrhosis with ascites)

Aldosterone antagonists

22

Why can loop/thiazide diuretics cause alkalosis?

Cause excretion of H+

23

How does aldosterone work?

1) Increases synthesis of Na+/K+ ATPase

2) Increases synthesis of a protein that activates the epithelial Na+ channel (ENAc)

24

Why do you give mannitol IV?

because it is membrane impermeable

25

Where does mannitol work?

Proximal tubule

26

How do carbonic anhydrase inhibitors work? (tricky)

Increase excretion of HCO3 with Na+, K+ and H2O (alkaline diuresis and metabolic acidosis will result)

27

How do carbonic anhydrase inhibitors work? (tricky)

Increase excretion of HCO3 with Na+, K+ and H2O (alkaline diuresis and metabolic acidosis will result)

28

What do V1 receptors mediate?

Mediate vasoconstriction

29

What do V2 receptors mediate?

H2O absorption

30

How do vaptans work?

Blockade of V2 receptors
-cause excretion of water without accompanying Na+
(thus raise plasma Na+ )

31

Drug used to treat SIADH

Tolvaptan

32

How is glucose reabsorbed at the apical/basolateral membrane

Secondary active transport (apical)

Facilitated diffusion (basolateral)

33

How do SGLT2 inhibitors work?

Excretion of glucose
Decrease in HbA1c
Weight loss

34

Where is PGE2 made?

The medulla

35

Where is PGI2 made?

Glomeruli

36

How do prostaglandins affect GFR?

-vasodilator effect on afferent arteriole
-release renin = vasoconstricts efferent arteriole

37

This acid is made by the catabolism of purines

Uric acid

38

How do uricosuric agents work?

(probenicid, sulfinpyrazole)

Block reabsorption of urate (don't cause enhanced excretion, just block reabsorption)