Flashcards in Pharmacology Deck (43)
Involves a disorder of glomerular filtration, allowing protein (largely albumin) to appear in the filtrate
The Nephrotic syndrome
Why does hepatic cirrhosis with ascites cause oedema?
Increased pressure in the hepatic portal vein, combined with decreased production of albumin, causes loss of fluid into the epritoneal cavity and oedema (ascites)
Where do carbonic anhydrase inhibitors work?
Proximal convoluted tubule and distal convoluted tubule
Where do loop diuretics work?
Thick ascending limb of the loop of henle
Where do thiazide diuretics work?
Distal convoluted tubule
Where do potassium sparing diuretics work?
OATs (organic anion transporters) transport which type of drug?
Transport acidic drugs
e.g. thiazides and loop agents
OCTs (organic cation transporters) transport which type of drug?
Transport basic drugs (e.g. triamterene and amiloride)
Are thiazide and loop diuretics acidic or basic?
Inhibit the Na+/K+/2Cl- carrier by binding to the Cl- site
e.g. Furosemide and Bumetanide
Furosemide and Bumetanide are which type of diuretic?
Type of diuretic that also possesses a vasodilator action?
Possess an additional, indirect, vasodilator action (mechanism uncertain) that contributes to their effectiveness in the treatment of hypertension (where they are used in combination with other antihypertensive agents
Cause up to 5% of Na+ to be excreted, producing a modest diuresis
The site of action of many diuretics is the _____ membrane of tubular cells?
At the basolateral membrane, organic ions (OA-) are enter the cell by either diffusion, or in exchange for what?
How is alpha-KG transported into a cell?
Via an Na+ decarboxylase transporter
MRP2 transports anions or cations?
MRP1 transports cations
Possess an additional, indirect venodilator action (before diuresis) that is beneficial in pulmonary oedema caused by heart failure
Can be used to treat acutely elevated calcium levels in the serum?
-these also cause excretion of magnesium and calcium
(remember there is a paracellular pathway in the thick ascending limb of the loop of henle, where Ca and Mg pass through
At the basolateral membrane, how do organic ions enter the cell?
Diffusion or in exchange for alpha-KG
How is alpha-KG transported into the cell?
Via Na+ decarboxylase transporter
At the apical membrane, how does OA- enter the lumen
Via MRP2 or OAT4 (in exchange for alpha-KG)
At the basolateral membrane, how do organic cations enter the cell?
Via diffusion or OCT
At the apical membrane, how do OC enter the lumen?
Via MRP1 or OC+/H+ antiporters
Type of diuretic that increases reabsorption of Ca?
Type of diuretic used in renal stone disease and nephrogenic diabetes insipidus?
Na+/H+ exchange blocked by what
Carbonic anhydrase inhibitors
Na+/K+/CL- cotransport blocked by what?
Na+/Cl- cotransport blocked by what?
Increase excretion of Ca2+ and Mg2+
These drugs also induce renal synthesis of prostaglandins, which contributes to their renal action including the increase in renal blood flow and redistribution of renal cortical blood flow.
Diuretics which could cause metabolic alkalosis?
Increase reabsorption of Ca2+
Possess venodilator action
Possess vasodilator action
Which type of diuretic used in renal stone disease?
Thiazide (reduce amount of calcium you are peeing out)
Which type of diuretic used in nephrogenic diabetes insipidus?
Diuretic which could cause male sexual dysfunction?
Diuretic which could cause impaired glucose tolerance?
What type of receptors does aldosterone bind to?
Why do loop and thiazide diuretics cause potassium loss?
Increase Na+ reabsorbed (collecting tubule)
This makes lumen more negative
K+ chucked out into the lumen and washed away
Potassium sparing diuretic
(poor absorption from GI tract)