Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmocolgy > Diurectics > Flashcards

Diurectics Flashcards

1
Q

What hormones are made in the kidney ?

A

renin, EPO, prostaglandins and Calcitriol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what does the kidney metabolise ?

A

Vit D, Polypeptides (insulin) , drugs such as morphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how does mannitol work ?

what is the main side effect?

A

increases the Osmolarity of the lumen moving more water into the lumen
hypernatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

where do loop diuretics work on ? what receptor?

A

thick ascending limb

NK2Cl receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

why do loop diuretics cause hypokalaemia ?

A

increased Na+ delivery late in tubule leads to incresed K+ loss from ENaC related Na+ absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the main side effects of Loop diuretics ?

A

hyponatremia , hypocalaemia, hypokalaemia and metabolic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how do thiazides work ?

A

block Na+/Cl- in DCT. not as potent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the side effects of thiazides ?

A

hypercalaemia , hypokalaemia , metabolic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the action of aldosterone on the kidney?

A

up regulation of ENaCa and Na/K/ATPase in principal cells of CD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what does amiloride do ?

A

blocks ENaC in the CD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what does spironolactone do ? how is it K+ sparing ?

A

blocks aldosterone receptor in CD which allows K+ not to be released via ROMK channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what do carbonic anhydrase diuretics do ?

A

block NaHCO3- reabsorption in PCT

can lead to acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does alcohol and caffeine cause diuresis ?

A

alcohol suppresses ADH

increased GFR and decreased Tubular Na+ reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

name 2 ADH antagonists

A

lithium - only water laves = hypernatremia

Tolvaptan - used in hyponatraemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the general ADRs of diuretics?

A

hypovalaemia and hypotension
AKI
electrolyte disturbances
anaphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are side effects of thiazides ?

A

Gout, hyperglyceamia, ED , hypercalaemia , Increases LDL and TG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are side effects of frusemide ?

A

alkalosis , ototoxicity , Gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the side effects if spironolactone ?

A

hyperkalaemia, impotence and gynaecomastia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what diuretics used in hypertension ?

A

Thiazide (as they can vasodilate)

spironolactone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what diuretics used in HF?

A

Loop and spironolactone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what diuretic used in liver disease?

A

spironolactone and loop

22
Q

what diuretic used in nephrotic syndrome ?

A

loop diuretic

+/- thiazide or K+ sparing w/ K+ supplements

23
Q

what is difference between primary and secondary hyperalodosterism ?

A

primary - low renin levels due to adrenal making too much aldosterone
secondary - high renin with hypotension due to body causing the adrenal glands to release too much aldosterone

24
Q

what diuretic used in CKD ?

A

Loop diuretic - alkalosis and k+ excretion is good

avoid K+ Sparing

25
Q

why can you build up a tolerance to diurectics in HF, Nephrotic syndrome and CKD ?

A

HF = Not enough blood circulating to deliver drug
Nephrotic = not enough protein to bind drug to
reduction in nephrons and OATs = CKD
Gut oedema can also stop absorption

26
Q

what are the steps you should take in refractory oedema ?

A 
check salt intake 
IV furosemide 
tritrate dose
give repeated bolus
need higher doses in HF
27
Q

why do thiazides cause hypo natraemia and kalamia the most ?

A

they work on the top bit of the nephron on the DCT so less like lt to affect the conc gradient so less water is lost compared to loop diuretic

28
Q

Name 3 nephrotoxic drugs

drugs shouldn’t be used in Renal dysfunction

A

Aminoglycosides - Gentamicin
IV Vancomyosin
Aciclovir
NSAIDs

ACE-i , diuretic, NSAIDs, metformin

29
Q

what happens in renal artery stenosis to AA and EA?

A

AA- dilates due to prostacyclin

EA- Constricts , ANG2

30
Q

What do NSAIDs and ACE-i do on the kidney ?

A

NSAIDs stop PGs = less dilation of AA

ACE-I stop ANG2 Which stops constriction

31
Q

what drugs should you be careful with in CKD?

A

Digoxin , heparin , gentamicin , opiates , cyclosporin

32
Q

what is the management of hyperkalaemia ?

A

Calcium gluconate - heart protection
insulin/dextrose
calcium resonium

33
Q

what are the general ADRs of diuretics?

A

hypovalaemia and hypotension
AKI
electrolyte disturbances
anaphylaxis

34
Q

what are side effects of thiazides ?

A

Gout, hyperglyceamia, ED , hypercalaemia , Increases LDL and TG

35
Q

What are side effects of frusemide ?

A

alkalosis , ototoxicity , Gout

36
Q

what are the side effects if spironolactone ?

A

hyperkalaemia, impotence and gynaecomastia

37
Q

what diuretics used in hypertension ?

A

Thiazide (as they can vasodilate)

spironolactone

38
Q

what diuretics used in HF?

A

Loop and spironolactone

39
Q

what diuretic used in liver disease?

A

spironolactone and loop

40
Q

what diuretic used in nephrotic syndrome ?

A

loop diuretic

+/- thiazide or K+ sparing w/ K+ supplements

41
Q

what is difference between primary and secondary hyperalodosterism ?

A

primary - low renin levels due to adrenal making too much aldosterone
secondary - high renin with hypotension due to body causing the adrenal glands to release too much aldosterone

42
Q

what diuretic used in CKD ?

A

Loop diuretic - alkalosis and k+ excretion is good

avoid K+ Sparing

43
Q

why can you build up a tolerance to diurectics in HF, Nephrotic syndrome and CKD ?

A

HF = Not enough blood circulating to deliver drug
Nephrotic = not enough protein to bind drug to
reduction in nephrons and OATs = CKD
Gut oedema can also stop absorption

44
Q

what are the steps you should take in refractory oedema ?

A 
check salt intake 
IV furosemide 
tritrate dose
give repeated bolus
need higher doses in HF
45
Q

why do thiazides cause hypo natraemia and kalamia the most ?

A

they work on the top bit of the nephron on the DCT so less like lt to affect the conc gradient so less water is lost compared to loop diuretic

46
Q

Name 3 nephrotoxic drugs

drugs shouldn’t be used in Renal dysfunction

A

Aminoglycosides - Gentamicin
IV Vancomyosin
Aciclovir
NSAIDs

ACE-i , diuretic, NSAIDs, metformin

47
Q

what happens in renal artery stenosis to AA and EA?

A

AA- dilates due to prostacyclin

EA- Constricts , ANG2

48
Q

What do NSAIDs and ACE-i do on the kidney ?

A

NSAIDs stop PGs = less dilation of AA

ACE-I stop ANG2 Which stops constriction

49
Q

what drugs should you be careful with in CKD?

A

Digoxin , heparin , gentamicin , opiates , cyclosporin

50
Q

what is the management of hyperkalaemia ?

A

Calcium gluconate - heart protection
insulin/dextrose
calcium resonium

Pharmocolgy (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions