Diuretics 2 Flashcards

1
Q

what is filtration fraction? (FF)

A

GFR / RPF = 0.2, thus about 20% of the plasma flowing through the glomeruli is ultrafiltered to form tubular fluid.

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2
Q

The thick ascending limb of the loop of Henle is the solute transport engine driving and maintaining the

A

counter current multiplication of interstitial solute concentration difference or solute concentration gradient extending from cortex to medulla surrounding
the collecting duct.

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3
Q

The early distal tubule is impermeable to water serving to further dilute the tubular fluid. However, the late distal tubule is

A

permeable to water when induced by an interaction with antidiuretic hormone (ADH).

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4
Q

Diuretics are drugs which increase the volume and rate of

A

urine output by decreasing the active reabsorption of solutes (saluretics) and/or water (aquaretics) in one or more segment of the nephron.

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5
Q

Aquaretics are drugs which decrease

A

the ability of ADH to increase the water permeability of the late distal tubule and collecting duct.

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6
Q

Lithium, fluoride (methoxy flurane) and demeclocycline are aquaretic drugs which

A

decrease ADH-induced water reabsorption by mechanisms not well understood.

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7
Q

Loop diuretics, thiazide diuretics and potassium sparing diuretics are saluretic drugs which decrease

A

solute reabsorption by either direct interaction with solute transport proteins in the luminal membrane or by interaction with intracellular receptors regulating
expression of solute transport proteins.

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8
Q

Osmotic diuretics are drugs which enter the tubular fluid by glomerular filtration and are neither

A

reabsorbed nor secreted along the nephron.

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9
Q

The presence of osmotic diuretics in the tubular fluid sufficiently increases its osmolarity to

A

oppose water and solute reabsorption along the nephron without specific interaction with solute transport proteins. Mannitol, excess glucose, urea and isosorbide act as osmotic diuretics when present in tubular fluid.

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10
Q

Diuretics change the volume and ion composition/concentration of the ECF by changing

A

the volume and ion composition/concentration of the urine. This is achieved primarily by decreasing reabsorption of sodium and associated ions as well as solute transport-driven, osmotically obligated water reabsorption in different segments of the nephron.

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11
Q

clearance is

A

UV / P

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12
Q
Free water clearance quantifies a time-dependent (rate)
function of the kidney to
A

eliminate or retain water, free of solutes, in preserving ECF volume and osmolarity.

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13
Q

Sodium reabsorption in the late distal tubule and

collecting duct is regulated by circulating levels of

A

aldosterone which varies according to the

prevailing sodium balance.

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14
Q

Sodium reabsorption in the late distal tubule and

collecting duct is functionally coupled to

A

potassium secretion. An increase or decrease in transcellular sodium reabsorption occurs simultaneously with an increase or decrease in transcellular potassium
secretion.

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15
Q

In the late distal tube and the collecting tube, the functional coupling of sodium reabsorption to
potassium secretion includes the regulation of
potassium secretion by

A

aldosterone.

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16
Q

what are diuretics?

A

drugs which increase the volume and rate of urine output by decreasing the active reabsorption of solutes and/or water in one or more segments of the nephron.

17
Q

what are the 3 main therapeutic usage of diuretics?

A
  1. hypertension
  2. edema
  3. calcemia and kalemia