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Flashcards in Pharmacology Deck (52):
1

What is oedema?

An imbalance between formation and absorption of interstitial fluid.

2

An increase in what pressure causes oedema?

Capillary hydrostatic pressure

3

A decrease in what can cause the formation of interstitial fluid?

Protein

4

What is nephrotic syndrome?

Glomerular filtration issue which allows protein in filtrate and therefore proteinuria.

5

If interstitial fluid collects, what does this do the blood volume?

Decreases it.

6

If blood volume is low, how is this corrected?

RAAS system activated

7

What does proteinuria look like?

Frothy

8

How does CHF cause oedema?

Reduced CO causes renal hypo perfusion which activates RAAS.
Increased capillary pressure leads to oedema.

9

How does hepatic cirrhosis with ascites cause oedema?

Increased pressure in hepatic portal vein and less albumin causes movement of fluid into peritoneum.
RAAS system activated.

10

Which diuretic works on TAL of loop of Henle?

Loop diuretics

11

Which diuretic works on DCT?

Thiazide diuretic

12

Where does potassium sparing diuretics work on?

Collecting tubule

13

At which membrane do diuretics work on?

Apical membrane on tubular cells

14

Which diuretic are acidic?

Thiazides and loop diuretics

15

Which transport systems work with acidic drugs?

Organic anion transporters (OAT)

16

What kind of substance is the anion swapped for at the basolateral membrane?

Ketone.
alpha- ketoglutarate.

17

What transporter do loop diuretics work on?

Triple transporter
Na+/K+/2Cl-

18

How do loop diuretics work?

Blocks triple transporter so sodium is retained in tubular lumen and gets peed out. Water follows sodium

19

Give an example of a loop diuretic

Furosemide

20

When would loop diuretics be used?

Acute pulmonary oedema
Chronic Heart failure
Ascites
HTN
Chronic kidney failure

21

What are the adverse effects of loop diuretics?

Potassium loss
Metabolic alkalosis
Hypovolaemia
Increased plasma uric acid

22

How do thiazide diuretics work?

Block the Na+/Cl- co-transporter in DCT

23

Give an example of a thiazide diuretic

Bendroflumethiazide

24

Where are thiazide diuretics used?

Mild heart failure
HTN
Resistant oedema
Nephrolithasis

25

Give an example of potassium sparing diuretics

Spironolactone.

26

How does spironolactone work?

Competes with aldosterone for binding to Na+/KATPase pumps

27

When are potassium sparing diuretics used?

In conjunction with agents that cause hypokalaemia or will cause HYPERkalaemia

28

Where do osmotic diuretics work?

PCT.

29

How do osmotic diuretics enter the renal system?

Glomerular filtration

30

Give an example of an osmotic diuretic

Mannitol

31

What effect does aldosterone have on Na+?

Na+ reabsorption to blood

32

What effect does aldosterone have on K+?

Secretion of K+

33

What effect does vasopressin have on water?

Increases water reabsorption

34

What are vaptans?

Competitive antagonists of vasopressin receptors

35

What effect do vaptans have on water?

Block V2 receptors which causes excretion of water.

36

What effect do vaptans have on sodium?

Do not change sodium levels but increase the concentration

37

What vaptans are available for use?

Conivaptan
Tolvaptan

38

When are vaptans used?

SIADH

39

What do SGLT2 co-transporters do?

Allow renal reabsorption of glucose in PCT

40

Where are SGLT1 cotranporters?

Intestine

41

How do SGLT2 cotransporters work?

Na+:glucose against a concentration gradient

42

What must a clinician remember when doing a urinalysis on a patient on SGLT2 inhibitor?

Glucosuria present

43

Name an SGLT2 inhibitor

Dapagliflozin

44

Why might SGLT2 inhibitors cause weight loss?

Calorific loss of glucose

45

What is a side effect of SGLT2 inhibitors?

Increased UTIs

46

Which prostaglandin affects the medulla?

PGE2

47

What do prostaglandins do?

Vasodilation, prevent sodium loss.

48

When are prostaglandins increased?

Trauma
Ischaemia
Bradykinin

49

What part of the kidney do prostaglandins affect?

Vasodilation of afferent arteriole

50

What hormone does prostaglandin release?

Renin from granular cells of juxtaglomerular apparatus

51

Which drugs inhibit prostaglandins?

NSAIDs

52

What effect will NSAIDs have in those with renal dysfunction?

Will cause acute renal failure and decrease GFR