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Z MD1 Renal block > pharmacology > Flashcards

Flashcards in pharmacology Deck (25)
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1

How do aquaretics reduce preload?

Vasopressin (ADH) receptor antagonists

2

where does gentomycin act in the kidney

on the apical membrane of the proximal tubule

3

clinical uses of osmotic diuretics

raised intracranial P intraoccular P prevention of acute renal tailure

4

clinical use of spironolactone

in combination with loop or thiazide diuretics heart failure hyperaldosteronism

5

how do aldosterone receptor antagonists reduce preload?

Inhibit aldosterone action on the cortical and distual tubules of the nephron (K+ sparing - monitor for hyperkalaemia)

6

adverse effects of loop diuretics

hypokalemia metabolic alkalosis hypovolaemia hypotension

7

adverse effects of spironolactone

hyperkalemia GI upset

8

where do the 4 types of diuretics act?

loop diuretics - ascending limb of loop of henle

thiazide diuretics - distal tubule

K+ sparing diuretics - collect duct

osomotic diuretics - mainly proximal tubule

9

onset and duration of triamterene and amiloride

tiamterene: onset - 2hours, duration 12-16hrs amilordie: onset: slow, duration 24 hours

10

furosemide is what kind of drug

Diuretic

11

clinical use for loop diuretics

salt and water overload hypertension

12

distal consequence of loop diuretics

increases the osmotic P in the distal tubule --> reducing water reabsorption in distal tubule

13

mechanism of diuretics

increase Na and water excretion from kidney lowering blood volume and blood pressure

14

mechanism of action of gentomycin toxicity on the kiney

bins to phsopholipids and effects calcium levels --> effects mitochondria --> cell damage --> apoptosis

15

mechanism of action of spironolactone

acts as an aldosterone R antagonist - decreases activation of Na channels in the Collecting duct - decreases the stimulation of Na pump synthesis this reduces osmotic P and therefore reduces water reabsorption

16

What is "The Triple Response"?

The actions of histamine: Reddening - due to vasodilatation at initiating site Wheal - due to increased vascular permeability (localised oedema response) Flare - spreading response through the sensory fibres

17

How do diuretics reduce preload

Act on the loop of Henle to decrease Na and Water reabsorption --> increase urine output --> decrease blood volume

18

onset and half life of spironolactone

slow onset short half life of 10 mins, but metabolite longer half life of 16 hours

19

mechanism of action of osmotic diuretics

decrease the passive reabsorption of water, with only a small decrease in Na reabsorption

20

3 types of drugs that can act on kindeys

1) diuretics 2) drugs that alter pH of urine 3) drugs that alter secretion of organic molecules

21

4 types of diuretics?

loop diuretics thiazide duiretics osmotic diuretics postassium sparing diuretics

22

mechanism of action of thiazide diuretics

inhibit the Na/Cl cotransporter in the distal convuluted tubule --> decreasing the osmotic P and therefore reducing water reabsorption

23

loop diuretics - mechanism of action

the Na/K/Cl carrier in the ascending limb of the loop of henle --> decreases the hypertonicity in the interstitium, decreasing osmotic P and therefore reduces water reabsorption

24

what are the effects of gentomycin kidney toxicity

proteinuria

decreased GFR

altered concentrating ability

25

where do antineoplastics act in the kidney

acts in the distal tubule and collecting duct