Brainscape's Knowledge GenomeTM

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


See full index

Pharm II > Diuretic Pharmacotherapy > Flashcards

Diuretic Pharmacotherapy Flashcards

1
Q

What is diuresis?

A

Process of producing more urine, More urine output decreases systemic volume and reduces edema

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

What is the most important ion in diuresis?

A

Na

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

When excess sodium is excreted, water follows and the result is increased ____

A

urine volume

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

What is natriuresis?

A

Excess sodium excretion in urine, Water follows salt, pull salt out and water will follow

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

What ions play minor roles in Diuresis?

A

K and Cl

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

Kidney initially filters ___ and other molecules such as glucose and urea at the ___

A

Na, K, Cl

At the glomerulus

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

Systemic concentration of these molecules (Na, K, Cl, Glucose and Urea) and urine concentration of these molecules is governed by _____ in distinct portions of the nephron

A

Rate/amount of reabsorption

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

What is the percentage of water reabsorbed in the PCT and what Diuretics work here?

A

65%

Acetazolamide and Osmotic Agents

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

What is the percentage of water reabsorbed in the Thick ascending limb and what diuretics work here?

A

15-25%

Loop agents

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

What is the percentage of water reabsorbed in the DCT and what diuretics work here?

A

4-8%

Thiazides

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

What is the percentage of water reabsorbed in the collecting tubule and what diuretics work here?

A

2-5%

Aldosterone antagonists

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

What diuretics work on the collecting duct?

A

ADH Antagonists and Osmotics Agents

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

What is reabsorption of 65% of filtered Na/K/Ca and Mg, 85% of NaHCO3 and nearly 100% of glucose and amino acids?

A

PCT

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

Bicarbonate + H =

A

Carbonic Acid

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

What is the function of Carbonic Anhydrase? CA

A

Breaks down carbonic acid in lumen AND forms bicarbonate and H from Carbon dioxide and water in PCT cells

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

Most relevant solutes to diuretics action are __ and ___ (In PCT)

A

NaHCO3 and NaCl

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

What Receptor do we have diuretics that will target it and what receptor dont we have diuretics that will target it?

A

Yes - CA Receptor

Dont - NHE3 Receptor

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

  • -
A
  • Pharmacologically block bicarbonate reabsorption by blocking carbonic anhydrase
  • Increase urinary pH, decrease total body pH
  • Highest permeability to water, so osmotic diuretics have the greatest effect here (mannitol)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

-
-

A
  • Hypochoremic alkalosis-> Hyperchloremic Acidosis
  • Urinary Ca/Phosphorus less soluble in urine with increased pH (Develop stones)
  • Not really used for “diuretic” effect bc does not appreciably affect Na (increase NaCl reabsorption in the rest of the nephron)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the site of action of Carbonic anhydrase inhibitors? and How do they work?

A

PCT

Block Bicarbonate Uptake

21
Q

What is the prototype of Carbonic anhydrase Inhibitors? and What are other types?

A

Acetazolamide - Prototype

Dichlorphenamide and Methazolamide - Others

22
Q 
Clinical indications of Carbonic anhydrase inhibitors? 
- 
- 
- 
-
A
  • Glaucoma (MC indication for CA Inhibitors, reduces aqueous humor formation)
  • Urinary alkalinization (Increasing pH of urine decreases uric acid, cystine and other weak acid reabsorption)
  • Metabolic alkalosis
  • Acute Mountain Sickness (Decreases CSF formation and pH)
23
Q 
Toxicity of Carbonic Anhydrase Inhibitors:
-
-
-
-
-
A
  • Hyperchloremic Metabolic Acidosis
  • Renal Stones
  • Renal Potassium wasting
  • Drowsiness
  • Nervous Systemic tox in patients with renal failure
24
Q

What is filtered by glomerulus but NOT REABSORBED and promotes water diuresis (More solute in lumen)?

A

Osmotic Diuretics

25
Q

Prototype of Osmotic Diuretics?

A

Mannitol

26
Q

Where do Osmotic Diuretics have major effects?

A

PCT and Descending limb of Loop of Henle

27
Q

-
-

A
  • Increase Urine volume
  • Decrease intracranial Pressure
  • Decrease intraocular Pressure
28
Q

-
-

A
  • Extracellular volume expansion
  • Dehydration (Hyperkalemic & hypernatremia)
  • Hyponatremia
29
Q

T/F: osmotic diuretics are filtered by the glomerulus but not reabsorbed.

A

TRUE

30
Q

Osmotic diuretics promote _______

A

water diuresis

31
Q

T/F: osmotic diuretics has a direct effect on ion transporters.

A

FALSE (NO direct effect)

32
Q

What is the protypical osmotic diuretic?

A

mannitol

33
Q

How must mannitol be given?

A

parenterally (poor oral absorption)

34
Q

Where do the major effects of osmotic diuretics occur?

A

In the PCT & the descending limb of loop of Henle

35
Q

What are the clinical indications of osmotic diuretics?

A
  1. increase urine volume (used when avid Na retention decreases efficacy of loop or thiazide)
  2. decrease intracranial pressure
  3. decrease intraocular pressure
36
Q

What toxicities occur with osmotic diuretics?

A
  1. extracellular volume expansion
  2. dehydration (hyperkalemia & hypernatremia)
  3. hyponatremia (due to impaired renal fxn, mannitol is retained IV & extracts water from cells causing dilution)
37
Q

Which transporter is found in the thick ascending limb of the LoH that is blocked by loop diuretics?

A

Na/K/2Cl co-transporter

38
Q

What are the clinical points for the thick ascending limb of the LoH?

A
  1. selectively block NaCl reabsorption, increasing the “salt” content of the urine, and therefore the water content.
  2. manipulating this section of the nephron can be very helpful in producing significant increases in urine volume and fluid loss.
39
Q

What are the global effects of the thick ascending limb of the LoH?

A
  1. increase salt & water loss at the expense of global K loss, as well as Ca & Mg loss
  2. great target for dz states associated with fluid accumulation and edema
  3. can be a drug target to help treat hyperkalemia & hypercalcemia
40
Q

T/F: loop diuretics indirectly inhibit Ca & Mg reabsorption

A

TRUE

41
Q

Which diuretics is the most effective in terms of urine volume?

A

loop diretics

42
Q

What are the prototypical loop diuretics?

A

furosemide and ethacrynic acid

43
Q

T/F: loop diuretics can be rapidly absorbed and eliminated by the kidney via glomerular filtration.

A

TRUE

44
Q

T/F: loop diuretics induce COX-2 expression

A

TRUE

45
Q

T/F: Loop diuretics decrease renal blood flow and GFR

A

FALSE (increase)

46
Q

Which transporter facilitates reabsorption of Na & Cl in the DCT?

A

Na/Cl transporter

47
Q

Which transporters promote Ca release to blood within the DCT?

A

Ca/Na countertransporter and Ca/H ATPase

48
Q

T/F: the DCT is relatively permeable to water.

A

FALSE (impermeable)

Pharm II (13 decks)

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