Pharmacology 3 Flashcards Preview

Renal > Pharmacology 3 > Flashcards

Flashcards in Pharmacology 3 Deck (43)
1

Are osmotic diuretics membrane permeable? And where is their major site of action?

They are membrane IMPERMEABLE = given IV

Major site of action is the proximal tubule (because this is where most iso-osmotic reabsorption of water occurs_

2

Mannitol

i.v. osmotic diuretic

3

Hyperglycemia and the use of iodine-based radiocontrast dyes in imaging may also result in which type of diuresis?

Osmotic diuresis

4

Acetazolamide

Carbonic anhydrase inhibitor

5

Type of drug used in
-glaucoma and following eye surgery
-prophylaxis of altitude sickness
-some forms of infantile epilepsy

Carbonic anhydrase inhibitors

6

Increase excretion of HCO3- with Na+, K+ and H2O – alkaline* diuresis and metabolic acidosis result

Carbonic anhydrase inhibitors

7

Lack of vasopressin secretion from the posterior pituitar

Neurogenic diabetes insipidus

8

Treatment for neurogenic diabetes insipidus?

Desmopressin

9

Does desmopressin increase blood pressure?

No

10

Ethanol and nicotine effects on vasopressin?

Ethanol inhibits secretion of vasopressin and nicotine enhances

11

Inability of the nephron to respond to vasopressin?

Nephrogenic diabetes insipidus
-no current pharmacological treatment

12

Nephrogenic diabetes insipidus inheritance?

X-linked recessive

13

Drugs which inhibit vasopressin?

Lithium
Demeclocycline
Vaptana

14

Canagliflozin, dpagliflozin and empaglifolzin

SGLT2 inhibtors

15

Most common adverse effects of SGLT2 inhibitors?

Genital bacterial and fungal infections

16

Treatment for acute urinary retention?

Immediately catheterise men and then offer alpha blocker before removing catheter

alpha blockers: alfuzosin, tamsulosin

17

Often presents in patients with chronic bladder outflow obstruction in association with uraemia, oedema, CCF, hypertension

Post-obstructive diuresis

This happens because you have retained urea, sodium and water =need to be diluted on excretion and you also have a defect in the concentrating ability of the kidney

18

Role of prostaglandins in obstruction

Ureter becomes blocked (e.g. by calculus) and then ureter releases prostaglandins in response

19

After how many months would calculus need intervention?

If not passed in 1 month then likely to require intervention

20

Treatment for infected hydronephrostomy?

Percutaneous nephrostomy

21

Indications to treat calculus urgently?

Pain unrelieved
Pyrexia
Persistent nausea/vomitting
High-grade obstruction

22

Treatment for clot retention?

3-way irrigating haematuria catheter

23

Investigations for frank haematuria?

CT urogram and cystoscopy

24

Torsion of spermatic cord presentation?

Usually sudden onset of pain, sometimes previous episodes of self limiting pain

25

Act as competitive antagonists of vasopressin receptors?

Aquaretics
Vaptans

26

These receptors mediate vasoconstriction

V1a

27

These receptors mediate H20 reabsorption in collecting tubule by directing aquaporin 2 (AQP2)-containing vesicles to the apical membrane

V2

28

Blockade of V2 receptors and the effect on water and Na+?

ade of V2 receptors causes excretion of water without accompanying Na+ and thus raises plasma Na+ concentration

29

Tolvaptan use?

Used in SIADH to correct hyponatremia

30

Where is SGLT1 expressed?

In the intestine (enterocytes) and the kidney

31

Where is SGLT2 expressed?

Almost exclusively confined to the proximal tubule

32

S1 vs S2 segment of proximal tubule and glucose reabsorption?

S1 segment --> 90% of glucose reabsorption
S2/S3 segment --> reabsorb up to 10% of filtered glucose, respectively

33

Method of glucose reabsorption at apical membrane?

secondary active transport

34

Reabsorption of glucose at basolateral membrane?

Facilitated diffusion

35

Inhibition of SGLT2 results in glucosuria and this mimics which condition?

Familial renal glucosuria (FRG)

36

Canagliflozin, dapagliflozin and empagliflozin are what type of drug?

SGLT2 inhibitors

37

What are prostaglandins formed from?

Formed from fatty acid arachidonic acid (by the cyclo-oxygenase enzymes)

38

Where is PGE2 made?

Medulla

39

Where is PGI2 (prostacyclin) made?

Glomeruli

40

Act as vasodilators, are natriuretic, and are synthesised in response to ischaemia, mechanical trauma, angiotenin II, ADH and bradykinin?

Prostaglandins

41

Prostaglandins and afferent and efferent arteriole?

Vasodilator effect on AFFERENT arteriole
Vasoconstrictor effect on efferent arteriole (because releases renin that leads to increased levels of angiotensin II)

42

Which type of drug may precipitate acute renal failure?

NSAIDS

43

"triple whammy effect"

ACEI