ADH hormone and diuretics (Trachte) - W2 Flashcards
Where do loop diuretics work and what are 2 examples?
- thick acending limb of loop of Henle
- furosemide, bumetanide
What is the MOA of loop diuretics and how do they effect urine NaCL, K+, blood pH, calcium?
- inhibit the Na, K, 2Cl pump
- prevents decrease in osmolarity
- Increase NaCl - hyponatremia
- increase K+ excretion - hypokalemia
- increases Ca2+ excretion - hypocalemia
- increases pH
What are the side effects of loop diuretics?
- impaired hearing
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What is the site of action of thiazides?
what are some examples?
- act in distal convoluted tubule
- chlorthalidone
- hydrocholorthiazide
- metalazone
MOA of thiazides.
Effect on urine NaCl, K, pH, Ca
- inhibit Na/Cl symporter
- increase NaCL excretion
- increase K+ excretion - decrease K+ reabsorption - acts in collecting tubule
- decreases Ca excretion - enhanced reabsorption in DCT through TRPV5.
- increases pH
What are some uses of thiazides?
- hypertension
- HF
- nephrolithiasis
- diabetes insipidus
What are side effects of thiazides?
- Hyperglycemia
- hyperuricemia - gout
- hypokalemia
- hyperlipidemia
- hyponatremia
- sulfur allergy
What drug class has a major effect as a vasodilator?
- Thiazides
- reduce calcium influx, reduce contraction.
Where do potassium sparing diuretics work and what are some examples?
- Cortical collecting tubule
- amiloride, triamterene
- Spironolactone, Eplerenone
What is the MOA of K+ sparing diuretics?
Effect on urine NaCl, K, pH, Ca
- Block ENAC or block aldosterone (spironolactone)
- Increase NaCl excretion.
- Decrease K+ excretion.
- Decreases pH
What are the major uses of K+ sparing diuretics?
- hyperaldosteronism
- prevent potassium wasting
What are side effects of K+ sparing diuretics?
- Hyperkalemia – arrythmias
- hyperchloremic metabolic acidosis
- gynecomastia
- acute renal failure
- kidney stones
Where does ADH act?
Examples?
Mechanism?
- Vasopression = natural. Desmopressin = synthetic.
- Site = collecting duct
- MOA = stimulation of G-protein coupled receptors in collecting duct to recruit aquaporin channels
- enhances water reabsorption.
Drug that is an ADH antagonist
convaptan
Drug that is an antibiotic with some activity as an ADH antagonist
Demecocycline
