diuretics Flashcards
what is the main unit of the kidney?
nephron
what is the function of glomerulus?
the place where the blood is filtrated
this segment carries out isosmotic
reabsorption of amino acids, glucose,
and numerous ions.
It is the major site for sodium chloride
and sodium bicarbonate reabsorption.
to which segment of the renal transport is this?
Proximal convoluted tubule
The proximal tubule is responsible for
100% of the total reabsorption of
sodium.
true or false?
false, 60-70%
there is No currently available drug directly acts
on NaCl reabsorption in the PCT
true or false?
true
bicarbonate is it basic or acidic component?
basic
what is the renal effect of carbonic anhydrase inhibitors?
bicarbonate diuresis
when the bicarbonate is depleted by CA inhibitors
what will happen?
metabolic acidosis
give examples of CA therapeutic usage
Acetazolamide, for urinary alkalinization, High altitude sickness, and Epilepsy
Dorzolamide, for glaucoma
what are the adverse effects of CA inhibitors?
Metabolic acidosis
Renal stones
Hypersensitivity reactions
Hyperammonemia
Intoxication with basic drugs
Severe COPD (respiratory acidosis)
are?
contraindication of CA inhibitors
Thick ascending loop of Henle has the?
– Na+, K+, and Cl-reabsorption
what is the main mechanism of the hick ascending loop of Henle ?
reabsorption of Ca2+ & Mg2+
what are the Loop diuretics?
Bumetanide, ethacrynic acid, furosemide,
torsemide
inhibition of NaCl reabsorption in the
Henle loop decreases the?
strength of the countercurrent concentrating
mechanism & causes greatly increased
urine output
The drugs increase Cl− more than Na+
excretion will lead to?
hyperchloremic alkalosis
to which cases we use the loop diuretics ?
Congestive heart failure, ascites, acute pulmonary edema
Severe hypercalcemia:
what are the adverse effects of Loop diuretics?
Hypovolemia: cardiovascular complications
* Hypokalemia: by mechanism (potassium wasting)
* Hyperuricemia: Volume depletion & diminished ability to concentrate urine
Ototoxicity
which segment actively pumps sodium
and chloride out of the lumen of the
nephron via the Na+/Cl– carrier?
Distal convoluted tubule
The distal convoluted tubule is
responsible for 5–8% of filtered sodium
reabsorption.
true or false?
true
Removal of the reabsorbed calcium back
into the blood requires ?
sodium-calcium exchange
Target of the thiazide diuretics is?
Distal convoluted tubule
Thiazide diuretics will cause?
Hypokalemic metabolic alkalosis may occur
Reabsorption of Ca from the urine is ↑
urine Ca content is ↓
Because thiazide diuretics act in a diluting segment of the nephron, thiazides may reduce the excretion of water and cause?
dilutional hyponatremia
when we can use the thiazide diuretics?
Hypertension
Edema associated with heart failure.
Hypercalciuria in patients who have recurrent urinary calculi
composed of calcium salts.
Nephrogenic diabetes insipidus
- Hypokalemia and hyperuricemia
- Hypercalcemia & hypomagnesemia
- Hyperglycemia: due to impaired pancreatic release of insulin.
- Hyperlipidemia
photosensitivity and dermatitis
fatigability and sexual impotence
are the adverse effects of?
Thiazide diuretics
which diuretics has the opposite effect of loop diuretic?
Thiazide diuretics
: the primary route of excretion of K+ is?
Kidneys
the main site of action for Potassium-sparing diuretics is?
cortical collecting duct, The aldosterone receptor and the sodium channels
Increase sodium loss by reducing the potassium excretion it can spare Potassium.
true or false?
true
what is the net result of potassium sparing diuretics?
Increase sodium loss by reducing the potassium excretion so you can spare.Potassium
Spironolactone and eplerenone have fast onsets and offsets of action (24–72 h)
true or false?
false, slow onset
Amiloride and triamterene have durations of action of 12–24 h
and, triamterene is extensively metabolized, it has a shorter half-life (4 hrs) and must be given more frequently than amiloride (half-life
21 hrs
true or false?
true
Hyperkalemia
Gynecomastia and antiandrogenic effects
Kidney stones
these are the adverse effects of?
K+-Sparing Diuretics
when we use the osmotic diuretics?
Increase the osmotic pressure of plasma & extract water from the eye and brain
control intracranial
pressure in patients with traumatic brain injury
prophylaxis of acute kidney injury
Osmotic diuretics increase the osmolality of the ECF compartment & shift water back into the extracellular compartment
true or false?
true
what are the adverse effects of osmotic diuretics?
Extracellular volume expansion
Dehydration, hyperkalemia, hyponatremia
Hyponatremia
Sodium-glucose cotransporter-2 is
important in the?
renal reabsorption of
glucose
