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Flashcards in Urology Drugs - Werner Deck (53):
1

What are the important drugs and substances that are ACTIVELY secreted in the PCT?

acids - probenicide, sulphinpyrazone
bases

2

What does probenicide compete with in the PCT?

penicillin

3

What does sulphinpyrazone compete with in the PCT?

uric acid

4

What kind of drugs do carnivores have delayed elimination of?

low pKa drugs

5

What chemicals have an effect on mesangial cells?

atrial natriuretic peptide - relax
sympathetic - contract
angiotensin 2 - constrict

6

What do carboanydrase inhibitors do?

increase excretion of bicarbonate with accompanying Na, K, and H2O

7

What are carboanhydrase drugs used to treat?

glaucoma

8

What is an example of carboanhydrase inhibitor?

acetazolamide

9

What is the effect of carboanhydrase on the urine?

mild alkaline urine --> metabolic acidosis

10

What part of the nephron is responsible for the countercurrent system?

loop of Henle

11

What parts of the loop of henle are water permeable?

descending limb

12

What are the most powerful diuretic drugs?

loop diuretics - furosemide, bumetanide, torasemide

13

What is the MOA of loop diuretic drugs?

inhibit Na/K/Cl carrier

14

How does loop diuretic drugs cause metabolic alkalosis?

increased Na in DT --> increased loss of H and K

15

What other molecules does loop diuretics affect?

increased loss of Ca and Mg, decreased loss of uric acid

16

What are the pharmacokinetic aspects of loop diuretics?

readily absorbed from GI, strongly protein bound, metabolized in liver

17

What are the SE of loop diuretics?

hypokalemia (and metabolic alkalosis, hypovolemia, hypotension)

18

What happens in the distal tubule?

active Na/Cl transport (dilution)
excretion of H and K (by Na/K pump)
calcium excretion

19

What are the 2 thiazide diuretics?

chlorothiazide and hydrochlorothiazide

20

What is the MOA of chlorothiazide?

blocks Na/Cl symport in DT

21

What other molecules does thiazide drugs effect?

K loss, excretion of uric acid and Ca decreased, excretion of Mg increased

22

What are the extra-renal effects of thiazide drugs?

vasodilation, hyperglycemia, reduce bone loss

23

What happens when thiazide drugs are used in hypertensive states?

initial fall in BP = increase in urine volume
later phase = direct action on BV

24

What are the clinical uses for thiazide diuretics?

hypertension, mild HF, central or nephrogenic diabetes insipidus

25

What are the renal SE of thiazides?

hypokalemia, metabolic alkalosis, increased uric acid in plasma

26

What are the non renal SE of thiazides?

hyperglycemia, increased plasma cholesterol, male impotence, hypersensitivity rxns

27

What do thiazide diuretics compete with to be excreted in the kidney?

uric acid

28

What do the principal cells reabsorb in the CD? What do they secrete?

Absorb: Na
Secrete: K

29

What do the intercalated cells do in the CD?

secrete H

30

What influences Na/Cl absorption in the CD?

aldosterone

31

What influences water reabsorption in the CD?

ADH/vasopressin

32

What is the quick effect of aldosterone on the CD?

stimulation of Na/H exchanger (membrane receptors)

33

What is the delayed effect of aldosterone on the CD?

cell receptors -->proteins that activate sodium channels

34

What drugs block the delayed effect of aldosterone in the CD?

amiloride and triamterene

35

What diuretic is a aldosterone receptor antagonist?

spironolactone

36

What increases the diuretic effect of K sparing diuretics?

high sodium load or aldosterone is high

37

What are the 2 clinical uses of K sparing diuretics?

increase K secondary to CHF
edema and ascites

38

What is the active metabolite of spironolactone?

canrenone - long half life

39

What are the SE of spironolactone?

GI, hyperkalemia, gynaecomastia, menstral, testicular, peptic ulcers

40

Which is more poorly absorbed? triamterene or amiloride?

amiloride

41

What do PGE2 and PGI2 influence on hemodynamics?

vasodilation in response to AG2 and norepinephrine mediated vasoconstriction

42

What influence does PGE2 and PGI2 have on renal control of NaCl and water?

increase renal blood flow and natriuresis(excretion of sodium)

43

What are the clinical indications of osmotic diuretics?

intracranial and intraocular pressure
prevention of acute renal failure

44

What are the side effects of osmotic diuretics?

transient expansion of ECF

45

What receptor does telmisartan bind to?

AT1 receptors

46

What kind of molecule is telmisartan?

lipophilic weak acid, binds reversibly

47

What drug can treat benign prostatic hyperplasia?

finasteride

48

What types of drugs should be used for acute prostatitis?

basic drugs (erythro, trimetho)
lipophilic drugs (flouro, chloram, TMPS)

49

What types of antibiotics should be used for cystitis?

small spectrum, cidal

50

What drugs have a effect on the bladder for incontinence?

parasympathicolytics, sympathomimetics

51

What types of drugs will have effects on the spincter of the bladder for incontinence?

smpathomimetics, oestrogens

52

What can treat urethral hypertonicity?

phenoxybenzamine, prazosine, diazepam, dantrolene

53

What is another name for urethral hypertonicity?

detrussor-urethral dyssynergia