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Specialized Pharmacology MN650 > Diuretics > Flashcards

Diuretics Flashcards

1
Q

What are the three natriuretic peptides ?

A

a. Atrial natriuretic peptide (ANP)
b. Brain natriuretic peptide (BNP)
c. C-natriuretic peptide

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2
Q

What triggers the release of ANP and BNP?

A

Stretching of the Atria and ventricles d/t increased preload

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3
Q

How do ANP and BNP reduce blood volume and increase venous capacitance?

A

a. shifting fluid into the extra vascular compartment by increasing vascular permeability
b. act on kidney = more H20 and Na loss
c. dilation of arteries and veins

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4
Q

What are the four parts open Nephron?

A

a. glomerulus
b. proximal convoluted tubule (PCT)
c. loop of henle
d. distal convoluted tubule

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5
Q

What two components make up the distal nephron?

A

Final segment of the distal convoluted tubule and the collecting duct

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6
Q

What are the three basic renal processes?

A

a. Filtration
b. reabsorption
c. active secretion

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7
Q

Where does filtration take place in the kidneys?

A

The glomerulus

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8
Q

What part of the nephron is responsible for reabsorption of sodium and chloride?

A

a. Proximal convoluted tubule (approx. 65%)
b. Thick segment of the ascending limb of the loop of Henle (20%)
c. Early segment of the distal convoluted tubule (10%)

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9
Q

Aldosterone works on which part of the nephron?

A

The distal nephron

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10
Q

Aldosterone is what type of steroid?

A

Mineralocorticoid

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11
Q

Aldosterone causes what effect in the distal nephron?

A

Sodium retention in potassium excretion

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12
Q

How does aldosterone promote sodium potassium exchange in the distal nephron?

A

Stimulates the synthesis of more sodium potassium transport pumps

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13
Q

What are the three classes of diuretics?

A

a. Loop diuretics
b. thiazide diuretics
c. Osmotic diuretics
d. potassium sparing diuretics

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14
Q

Where does mannitol act within the nephron?

A

Proximal convoluted tubule

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15
Q

Where does lasix act within the nephron?

A

Thick segment -ascending limb of the loop of Henle

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16
Q

Where do thiazides act within the nephron?

A

Early distal convoluted tubule

17
Q

Where does spironolactone act within the nephron?

A

Distal nephron

18
Q

What is the mechanism of action for furosemide?

A

Blocking reabsorption of sodium and chloride in the thick segment of the ascending limb of the loop of Henle

19
Q

Diuresis begins and lasts for how long after oral administration of furosemide?

A

a. 60 mins

20
Q

Where is furosemide metabolised and how is it excreted?

A

a. Metabolized by the liver

b. excreted by the kidneys

21
Q

What are the indications for Furosemide?

A

a. Pulmonary edema associated with CHF
b. Edema of hepatic, cardiac, or renal origin
c. uncontrolled hypertension

22
Q

Why is furosemide effective in patients with severe renal impairment?

A

Camp remote diuresis even when Reno blood flow and GFR are low

23
Q

What are adverse effects of Loop and thiazide diuretics?

A

a. hyponatremia
b. hypochloremia
c. hypokalemia
d. hypotension
e. ototoxicity
f. Hyperglycemia
g. Decreased HDL
h. increased LDL

24
Q

Combining digoxin and furosemide can have what negative effect?

A

Ventricular dysrhythmias r/t digoxin toxicity

25
Q

How does furosemide cause digoxin toxicity?

A

By reducing potassium levels

26
Q

Ethacrynic acid is what class of drugs?

A

Loop diuretic

27
Q

Torsemide is what class of drug?

A

loop diuretic

28
Q

Bumetanide is what class of drug?

A

Loop diuretic

29
Q

What is the mechanism of action for thiazide diuretics?

A

Blocks reabsorption of sodium and chloride any early segment of the distal convoluted tubule

30
Q

Diuresis begins, peaks, and lasts for how long after oral admin of thiazide diuretic?

A

a. Begins: 2 hrs
b. Peaks: 4-6 hrs
c. Lasts: 12 hrs

31
Q

What are the indications for hydro chlorothiazide?

A

a. Hypertension
b. Edema associated with mild to moderate heart failure
c. edema associated with hepatic or renal disease

32
Q

What is spironolactone’s the mechanism of action?

A

aldosterone antagonist

33
Q

What are the adverse effects of Spironolactone?

A

a. Hyperkalemia
b. Gynecomastia
c. menstrual irregularities
d. impotence
e. hirsutism

34
Q

Triamterene is what class of drug?

A

a. Potassium sparing diuretic

35
Q

Amiloride is what class of drug?

A

a. Potassium sparing diuretic

36
Q

Diuresis begins and lasts for how long after oral admin of spironolactone?

A

a. Onset: 24-48 hrs

b. Lasts: 48-72 hrs

37
Q

Diuresis begins and lasts for how long after oral admin of Triamterene?

A

a. Onset: 2-4 hrs

b. Lasts: 12-16 hrs

Specialized Pharmacology MN650 (28 decks)

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