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Pharmacology > CHAP 15: DIURETICS > Flashcards

CHAP 15: DIURETICS Flashcards

1
Q

what is diuretics

A

increase production of urine
or
increase the amount of water and salt expelled from the body as urine

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2
Q

what is natriuretic

A

increase in renal sodium excretion

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3
Q

what is aquaretic

A

increase excretion of solute free water

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4
Q

what do you call these agents result in increased urine output and increased urea excretion but not increased excretion of electrolytes.

A

aquaretics

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5
Q

Sodium bicarbonate (NaHCO3), sodium chloride (NaCl),
glucose, amino acids, and other organic solutes are reabsorbed via specific transport systems in the early proximal tubule

A

sodium bicarbonate, sodium chloride co-transporter

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6
Q

potassium ions are reabsorbed via?

A

paracellular pathway

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7
Q

what channel absorbs water passively

A

through a transcellular pathway ( aquaporin-1 [AQP1])
and
paracellular pathway (claudin-2)

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8
Q

As tubule fluid is processed along
the length of the proximal tubule, the luminal concentrations of most solutes decrease relative to the concentration of ____, an experimental marker that is filtered but neither secreted
nor absorbed by renal tubules.

A

inulin

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9
Q

approximately __% of filtered sodium ions, __% of the NaHCO3, __% of the potassium, __% of water and virtually all of the filtered glucose and amino acids are reabsorbed by the proximal tubule in normal
humans

A

66%
85%
65%
60%

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10
Q

drug that blocks sodium bicarbonate (NaHCO3) reabsorption in the proximal tubule

A

carbonic anhydrase inhibitors

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11
Q

sodium bicarbonate (NaHCO3) reabsorption by the PCT is initiated by the action of

A

sodium hydrogen exchanger

Na+/H exchanger (NHE3)

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12
Q

where does sodium hydrogen exchanger located

A

in the luminal membrane of the proximal tubule epithelial cell

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13
Q

function of sodium hydrogen exchanger

A

allows Na+ to enter the cell from the tubular lumen in exchange for H+ proton from inside the cell

sodium in, hydrogen out

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14
Q

why does the body need to pump Na+/K-ATPase in the basolateral membrane?

A

to maintain a low intracellular Na concentration

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15
Q

hydrogen is secreted into the lumen and combines with bicarbonate to form?

A

carbonic acid

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16
Q

on the lumen, the carbonic acid is rapidly dehydrated to ___ and ___ by ___

A

carbon dioxide and water by carbonic anhydrase

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17
Q

Carbon dioxide produced by dehydration of carbonic acid enters the proximal tubule cell by what diffusion?

A

simple diffusion

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18
Q

carbon dioxide is rehydrated back to carbonic acid by what enzyme?

A

intracellular carbonic anhydrase

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19
Q

after dissociation of carbonic acid in the PCT, the hydrogen is available for transport by what exchanger?

and the HCO3 or bicarbonate is transported out of the cell by what transporter?

A

sodium hydrogen exchanger (NHE3)

basolateral membrane transporter

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20
Q

bicarbonate reabsorption by the proximal tubule is dependent on what enzyme activity?

A

carbonic anhydrase

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21
Q

what drug can inhibit carbonic anhydrase

A

acetazolamide

22
Q

where can we find the Na/K ATPase in the PCT?

A

in the basolateral membrane

purpose?
to maintain intracellular sodium and potassium levels within the normal range

23
Q

a cotransporter that is responsible for reabsorbing much of the glucose that is filtered by the glomeruli?

A

sodium-glucose cotransporter SGLT2

24
Q

what disease is approved in treating diabetes mellitus in blocking SGLT2?

A

diabetes mellitus

25
Q

in what part of the PCT does it secrete organic acids such as uric acid, NSAID, diuretics, etc.

A

in the middle third
of the straight part of the proximal tubule (S2 segment).

26
Q

organic base secretory system of PCT is located in what segment of the PCT

A

early S1 and middle S2 segments of the proximal tubule

27
Q

transporter or organic acid and base in PCT

A

acid transport and base transporter

28
Q

___ is extracted from the descending limb of this loop by osmotic forces found in the hypertonic medullary interstitium

A

water

29
Q

thin ascending limp is relatively ___ impermeable but is permeable to some sloutes

A

water impermeable

30
Q

function of thin ascending limb?

A

passive reabsorption of water

31
Q

transporter found in thin ascending limb?

A

aquaporins

32
Q

thick ascending limb reabsorbs ___ from the lumen

A

NaCl sodium chloride

33
Q

nearly impermeable to water

A

thick ascending limb

34
Q

why is thick ascending limb called a diluting segment?

A

because salt reabsorption dilutes the tubular fluid

35
Q

The NaCl transport system in the luminal membrane of the TAL

A

Na+/K+/2CL+ cotransporter (NKCC2 or NK2CL)

36
Q

term called for diuretic agents that blocks NKCC2 transporter

A

“loop” diuretics

37
Q

since NKCC2 contributes to excess potassium accumulation within the cell. what do you call the channel for potassium to diffuse back into the tubular lumen?

A

ROMK channel

Renal Outer Medullary Potassium channel

38
Q

back diffusion of potassium into the tubular lumen causes?

A

causes a lumen positive electrical potential that provides the driving force for reabsorption of magnesium and calcium via paracellular pathway

39
Q

only 210% are filtered NaCl is reabsorbed

A

DCT

40
Q

primary transporter in the luminal membrane

A

NKCC2

41
Q

primary sodium and chloride transporter in the luminal membrane

A

(NCC) Na / Cl transporter

sodium chloride cotransporter

42
Q

is there a lumen positive potential in the DCT segment?

A

no. therefore calcium and magnesium are not driven out of the tubular lumen by electrical forces

43
Q

what ions are actively reabsorbed by DCT epithelial cell?

A

calcium

44
Q

what channels are used in actively reabsorbed calcium

A

apical calcium channel

and

basolateral Na / Ca exchanger

this process is regulated by parathyroid hormone

45
Q

collecting tubule system connects the DCT to the?

A

renal pelvis and the ureter

46
Q
A
47
Q

How many % does the collecting tubule system reabsorbs NaCl by the kidney?

A

2-5%

48
Q

The final site of NaCl reabsorption

A

Collecting tubule system

49
Q

A part of the tubule transport system where it is tightly regulated by the body fluid volume for determining he final Na concentration of urine

A

Collecting tubule system

50
Q

A site at which mineralocorticoids exert a significant influence

A

Collecting system

51
Q

The most important site of potassium section by the kidney and the site at which virtually all diuretic-induced changes in potassium balance occur

A

Collecting system

52
Q

What cells are the major sites of sodium, potassium and water transport

A

Principal cells and the intercalated cells

Pharmacology (15 decks)

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