Flashcards in Pharmacology Deck (52):
What is oedema?
An imbalance between formation and absorption of interstitial fluid.
An increase in what pressure causes oedema?
Capillary hydrostatic pressure
A decrease in what can cause the formation of interstitial fluid?
What is nephrotic syndrome?
Glomerular filtration issue which allows protein in filtrate and therefore proteinuria.
If interstitial fluid collects, what does this do the blood volume?
If blood volume is low, how is this corrected?
RAAS system activated
What does proteinuria look like?
How does CHF cause oedema?
Reduced CO causes renal hypo perfusion which activates RAAS.
Increased capillary pressure leads to oedema.
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.
Which diuretic works on TAL of loop of Henle?
Which diuretic works on DCT?
Where does potassium sparing diuretics work on?
At which membrane do diuretics work on?
Apical membrane on tubular cells
Which diuretic are acidic?
Thiazides and loop diuretics
Which transport systems work with acidic drugs?
Organic anion transporters (OAT)
What kind of substance is the anion swapped for at the basolateral membrane?
What transporter do loop diuretics work on?
How do loop diuretics work?
Blocks triple transporter so sodium is retained in tubular lumen and gets peed out. Water follows sodium
Give an example of a loop diuretic
When would loop diuretics be used?
Acute pulmonary oedema
Chronic Heart failure
Chronic kidney failure
What are the adverse effects of loop diuretics?
Increased plasma uric acid
How do thiazide diuretics work?
Block the Na+/Cl- co-transporter in DCT
Give an example of a thiazide diuretic
Where are thiazide diuretics used?
Mild heart failure
Give an example of potassium sparing diuretics
How does spironolactone work?
Competes with aldosterone for binding to Na+/KATPase pumps
When are potassium sparing diuretics used?
In conjunction with agents that cause hypokalaemia or will cause HYPERkalaemia
Where do osmotic diuretics work?
How do osmotic diuretics enter the renal system?
Give an example of an osmotic diuretic
What effect does aldosterone have on Na+?
Na+ reabsorption to blood
What effect does aldosterone have on K+?
Secretion of K+
What effect does vasopressin have on water?
Increases water reabsorption
What are vaptans?
Competitive antagonists of vasopressin receptors
What effect do vaptans have on water?
Block V2 receptors which causes excretion of water.
What effect do vaptans have on sodium?
Do not change sodium levels but increase the concentration
What vaptans are available for use?
When are vaptans used?
What do SGLT2 co-transporters do?
Allow renal reabsorption of glucose in PCT
Where are SGLT1 cotranporters?
How do SGLT2 cotransporters work?
Na+:glucose against a concentration gradient
What must a clinician remember when doing a urinalysis on a patient on SGLT2 inhibitor?
Name an SGLT2 inhibitor
Why might SGLT2 inhibitors cause weight loss?
Calorific loss of glucose
What is a side effect of SGLT2 inhibitors?
Which prostaglandin affects the medulla?
What do prostaglandins do?
Vasodilation, prevent sodium loss.
When are prostaglandins increased?
What part of the kidney do prostaglandins affect?
Vasodilation of afferent arteriole
What hormone does prostaglandin release?
Renin from granular cells of juxtaglomerular apparatus
Which drugs inhibit prostaglandins?