biochem dwuggy2 Flashcards
loop diuretic where site and what mechanism
loop of henle (thick ascending limb)
inhibition of na+, k+ and cl-
loop diuretic mech of act (furosemide)
acts on cl-binding site and directly inhibit carrier
causes LESS water to be absorbed into blood
MORE urine to LESS blood volume
loop diuretic indications
prescribed to treat water imbalances associated w/ congestive heart failure and kidney failure and pulmonary oedema
symptoms of loop diuretic
shortness of breath as result of water retention in lungs and swelling of lower extremities
what do loop diuretics do to blood volume venous pressure etc.
decrease blood volume and venous pressure, leading to increase capillary fluid reabsorption and decreased water retention (reduction in oedematous fluid)
loop diuretics used for hpb?
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for certain patients, those that have lost >50% kidney function
what prescribed for vast majority of patients
side effects of loop diuretics stop hpb and thiazides prescribed for vast majority of patients
loop diuretic contraindications
low k levels associated (hypokalemia), increases risk of digitalis toxicity, (medicine prescribed for congestive heart failure)
corticosteriods further reduce levels of k in blood
ABs derived from aminoglycoside can increase risk of hearing loss and kidney damage when taken w/ loop diuretics
NSAIDs such as aspirin and naproxen reduce the effect of loop diuretics.
thiazide diuretics used for (bendroflumethiazide)
treat high blood pressure and congestive heart failure % oedema arising due to heart failure, cirrhosis, chronic kidney failure, corticosteroid medications, and nephrotic syndrome
how do thiazide diuretics work
nhibit reabsorption of Na+ and Cl− from distal convoluted tubules in the kidneys by blocking the thiazide-sensitive Na+-Cl− symporter
what do thiazide diuretics do at distal tubule
increases Ca2+ reabsorption at the distal tubule
thiazide diuretic contraindications
hypotension
gout
renal failure
lithium therapy
hypokalaemia
may worsen diabetes
why TDs make precipitate gout
clearance of uric acid reduced since they compete for the same transporter, raises levels of uric acid in blood (so prescribed w/ caution in patients w/ gout or hyperuricemia)
why TDs make diabetes worse
chronic administration is associated with hyperglycemia
why TDs cause hypokalaemia
thiazides cause loss of blood potassium, while conserving blood calcium
