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PHARMA > 2B : DIURETICS > Flashcards

2B : DIURETICS Flashcards

1
Q

Baroreceptor is located in

A

carotid
sinus and aorta

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2
Q

Primary autonomic
mechanism for
blood pressure
homeostasis

A

Baroreceptor Reflex

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3
Q

involves sensory input from carotid
sinus and aorta to the vasomotor
center and output via PSNS and SNS

A

Baroreceptor Reflex

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4
Q

The most important DIURETICS for treating
hypertension are the

A
  1. THIAZIDES
  2. LOOP DIURETICS
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5
Q

for mild and moderate HPN

A

Thiazide

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6
Q

for severe HPN and HPN
emergencies

A

Loop

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7
Q

5 classes of diuretics

A
  1. CARBONIC ANHYDRASE INHIBITOR
  2. LOOP DIURETICS
  3. THIAZIDES
  4. K+ SPARRING DIURETICS
  5. OSMOTIC DIURETIC
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8
Q

diuretics acting on PROXIMAL convuluted tubules

A

CARBONIC ANHYDRASE INHIBITOR

ex., acetazolamide

proksimal=karbonik

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9
Q

diuretics acting on THICK ASCENDING LIMB

A

loop diuretics

ex., furosemide

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10
Q

acting on distal convuluted tubule

A

thiazides

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11
Q

acting on CORTICAL COLLECTING TUBULES

A

potassium sparring diuretics

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12
Q

drugs that modify SALT EXCRETION

A
  1. CARBONIC ANHYDRASE INHIBITOR
  2. LOOP DIURETICS
  3. THIAZIDES
  4. K+ SPARRING DIURETICS
  5. OSMOTIC DIURETIC
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13
Q

Drugs that modify WATER EXCRETION

A
  1. ADH agonists (desmopressin)
  2. ADH antagonist (conivaptan)
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14
Q
  • Filters large quantities of plasma
  • Reabsorbs substances the body conserve
  • Leave behind and/or secrete substances that must be eliminated
A

KIDNEY

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15
Q

Structural and Functional
Unit of the kidneys

A

NEPHRON

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16
Q

There are two major
TYPES
of nephrons:

A
  1. CORTICAL NEPHRON
  2. JUXTAMEDULLARY
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17
Q
  • 75% of nephrons
  • Located in the renal cortex
  • With shorter loops of henle
  • Has peritubular capillaries
A

CORTICAL NEPHRON

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18
Q
  • **25% **of nephrons
  • located in the corticomedullary junction
  • with longer loops of henle
  • Has vasa recta
A

JUXTAMEDULLARY

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19
Q

There are two major
PARTS
of nephrons:

A
  1. RENAL or MALPIGHIAN
    CORPUSCLE
  2. RENAL TUBULES
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20
Q
  • Afferent & Efferent arterioles,
  • Glomerular capillaries,
  • Podocytes,
  • Mesangial cells,
  • JG cells,
  • Bowman’s capsule
A

RENAL or MALPIGHIAN
CORPUSCLE

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21
Q

Parts of Renal tubules

A

PCT- Proximal Convoluted Tubule
LH - Loop of Henle
DT - Distal Tubule
CD - Collecting Duct

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22
Q

parts of Loop of Henle

A
  • Descending LOH
  • Thin Ascending LOH
  • Thick Ascending LOH
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23
Q

parts of distal tubule

A
  1. First part: Early Distal Tubule
  2. Second part: Late Distal Tubule/Connecting
    tubule,** cortical collecting tubule**
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24
Q

part of collecting duct

A
  1. Medullary Collecting Tubule
  2. Collecting Duct
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25
Q

Workhorse
of the nephron

A

Proximal Convoluted Tubule

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26
Q

transporter that reabsorbps 100 %
of filtered glucose, amino acids
(isosmotic)

A

SGLT2 cotransporter

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27
Q

what is being secreted in proximal convoluted tubule

A

Excess acids

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28
Q

it has

  • (+) microvilli and convolutions
  • where Isosmotic fluid reabsorption (from lumen to capillaries) happens
  • Most susceptible to toxins
A

Proximal Convoluted Tubule

29
Q

what are being reabsorb in early PCT

A

Site for reabsorption of Na,
H20, HC03 and glucose

  1. Na
  2. H20
  3. HCO3
  4. Glucose
30
Q

histology of PCT

A
  1. Simple cuboidal or Columnar epithelial cells
  2. Long microvilli
  3. cytoplasm is more eosinophilic than distal convoluted tubules and collecting duct
31
Q

descending limb of loop of henle is permeable to

A

water

DESCENDING-Permeable to WATER

32
Q

descending limb of loop of henle is impermeable to

A

solutes

33
Q

ascending limb of loop of henle is permeable

A

solutes

ASCENDING-permeable to SOLUTES

34
Q

ascending limb of loop of henle is impermeable to

A

water

35
Q
  • Also called
    diluting segment
  • where can you find N-K-2CL symport
A

Ascending limb

36
Q
  • Also called “cortical
    diluting segment”
  • Site of
    Macula Densa
A

Early Distal Tubule (EDT)

37
Q

two type of cell in Late Distal Tubule (LDT)

A
  1. principal cells
  2. intercalated cells
38
Q

Site of action of
Aldosterone

A

Late Distal Tubule (LDT)

in aldosterone you can form the world LATE; dos=distal t=tubule

39
Q

Reabsorb: Na+ and
water

Secrete: K+

A

Principal cells

40
Q

Reabsorb: K+

Secrete: H+

A

Intercalated cells

41
Q

Site of ADH** (antidiuretic hormone)**
action

A

Collecting Duct

42
Q

mechanism of AdH

A
  • Increase ADH –>
    increase
    aquaporin 2
    channels     –>
    increase
    reabsorption
43
Q

transporter for amino acids, nucleosides, sugars

A

uniporter (one molecule)

44
Q

transporter which movement is in the same direction like Na+/glucose co transporter in the intestine

A

Symporter/cotransporter

45
Q

type of transporter of Cl-/HCO3- exchanger in the red blood cell

A

antiporter/exchanger

46
Q

reabsorption of water, ions and all organic nutrients

A

proximal convoluted tubule

47
Q

secretion of ACIDS, DRUGS TOXINS

variable reabsorption of water, sodium ions, and calcium ions (under hormonal control)

A

distal convoluted tubule

48
Q

variable reabsorption of water and absorption or secretion of sodium, potassium, hydrogen and bicarbonate ions

A

connecting tubules and collecting duct

49
Q

delivery of urine to minor calyx

A

papillary duct

50
Q

further reabsorption of water (descending limb) and both sodium and chloride ions (ascending limb)

A

loop of henle

51
Q

production of filtrate

A

renal corpuscle

52
Q

movement from
Glomerular capillaries to Bowman’s space

A

Glomerular Filtration

53
Q

Glomerular Filtrates
volume & composition is
altered by:

A
  1. Tubular reabsorption
  2. Tubular secretion
54
Q

movement from** tubules**
to interstitium to peritubular capillaries

A

Tubular reabsorption

55
Q

movement from peritubular
capillaries to interstitium to tubules**

A

Tubular secretion

56
Q

measurement of the excretion and plasma level of a substance that is freely filtered

A

GFR

57
Q

excretion =

A

Filtration - reabsorption + secretion

58
Q

mechanism of diuretics action

A

1.** inhibit enzymes**
2. exert effects on specific membrane transport in tubular
epithelial cells
3. decrease rate of Na+
reabsorption from the tubules
4. exert osmotic effects
5. interfere with hormone receptors

59
Q

Principles of Diuretic Action

A
  1. Increase urine flow
  2. Increase excretion of Na+ & an accompanying anion
    (usually Cl)
  3. Most clinical applications of Diuretics: reduction of ECF
    fluid volume by decreasing total body NaCl content
  4. Modify renal handling of other
    cations , anions, uric acid
  5. May indirectly alter renal
    hemodynamics
60
Q

Natriuresis
is Finite because

A

renal compensatory
mechanisms bring Na+ excretion in line with Na+ intake

61
Q

Braking & Compensatory mechanisms:

A

ANS activation, RAAS activation, ↓ aBP , renal epithelial cell hypertrophy, increased expression
of renal epithelial transporters, alterations in natriuretic hormones

62
Q

drugs under Carbonic
Anhydrase
inhibitor

A

Acetazolamide
Dorzolamide
Brinzolamine
Dichlorphenamide
Methazolamine

63
Q

drugs acting on Thick ascending limb of loop of henle

A

LOOP DIURETICS

Furosemide
Bumetanide
Torsemide
Ethacryanic ACID

64
Q

DRUGS UNDER THIAZIDE DIURETICS

A

Hydrochlorothiazide
Chlorthalidone
Indapamide
Metolazone
Bendroflumethiazide
Polythiazide

65
Q

Potassium Sparing
Diuretics drugs

A

Spironolactone
Eplerenone
Amiloride
Triamterene

66
Q

MR Antagonists

A

Spironolactone
Eplerenone

67
Q

ENaC inhibitor

A

Amiloride
Triamterene

68
Q

drugs under Osmotic
Diuretic

A

Mannitol
Glycerin
Isosorbide
Urea

PHARMA (29 decks)

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