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Flashcards in Renal Pharm Deck (19):
1

Acetazolamide

C. A. Inhibitor --> Proximal Convoluted Tubule

Causes Bicarbonate and Na Loss in Urine.

2

Mannitol

Osmotic Diuretic --> Proximal Convoluted Tubule.

Increase Urine Formation with small Na and ions. Used for Dialysis disequlibrium and to reduce ICP and I-Occular-Pressure.

3

Furosemide

Loop Inhibitor --> TALH --> Na-K-Cl symport inhibition.
Make the Macula Densa Inable to sence NaCl. This results in copious diuresis and NaCl loss as well as increased K+/H+ secretion.

Kidney will not be able to concentrate urine.

**Do not give with Li, Indomethacin, Probenecid or warfarin.

4

Bumetanide

Loop Diuretic --> 40x stronger than fluorosamide. Used for patients who are on warfarin which is contraindicated for use with furosemide.

5

How do carbonic Anhydrase Inhibitors work ?

Inhibit CA resulting in bicarbonate loss in the urine. Causes Alkaline urine due to Na+ Bicarbonate Loss.
*Enhances Cl reabsorption resulting in acidosis

6

What are the adverse effects of CA inhibitors ?

Metabolic acidosis and markedly increased K+ loss in the urine.

7

How do osmotic diuretics work ?

Small molecules are filtered not absorbed by the kidney.

8

Where in the kidney do osmotic diuretics work ?

What is their indication for use ?

They have minor effects in the proximal convuluted tubule but their major mechanism of action is in the Loop of Henle

Treatment of dialysis disequlibrium syndrome
Reduce ICP
Reduce Intraoccular pressure

9

How do osmotic diuretics work ?

They increase Urine with small increments of NaCl and other ions.

10

What is a osmotic diuretic in lecture and what are its side effects ?

Mannitol, The side effects are volume overload and they are contraindicated in cardiac failure.

11

How do loop diuretics work ?

They inhibit the Na-K-2Cl symporter in the Thick Ascending Loop of Henle.

This makes the Macula Densa inable to sence NaCl.

12

What will loop diuretics do to the kidney ?

They will increse total renal blood flow. Stimulate synthesis of prostaglandins. Maintain GFR

13

How can loop diuretics increase renin production ?

1. Inhibit the macula densa
2. reflexively activate the sympathetic NS.
3. Stimulate Intrarenal Barioreceptor mechanisms

14

What are the net effects of Loop Diuretics ?

Most potent class in Mobilizing NaCl.
Significant NaCl loss.
Increased Urinary excretion of Ca2+ and Mg2+
Impair the ability of the kidney to concentrate urine.

15

What is Furosemide ?

A loop Diuretic. (X) NaCl reabsorption in TALH.
Given IV / IM.
Wide margin of safety.

**Dose response curve is altered by renal disease
**Extensively protein bound and excreted in the urine.

16

What are the pharmalogical effects of Flurosemide ?

Increased Urinary secretion of K+ and H+
Increased urinary secretion of Ca2+ and Mg2+.
Increase Prostaglandins and venous capacitance.

17

What are the adverse effects of Fluorosamide ?

Abnormalities in electrolytes. Hypokalemia and alkalosis.
Elevated BUN hyperglycemia and hyperuricemia.

**Ototoxicity and Sialadentitis
**Dont give with Li

18

What is Bemetanide ?

40x stronger of a loop diuretic than Fluorosamide. substituted for patients on Warfarin who need Fluorosamide.

19

What is Torsemide ?

A diuretic loop inhibitor that also lowers Blood Pressure. Has the longest half life and can be given once daily.