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Sketchy Pharm- CV and Renal drugs- LAH > Diuretics: Ch. 2.1- Acetazolamide, mannitol > Flashcards

Diuretics: Ch. 2.1- Acetazolamide, mannitol Flashcards

1
Q

By the end of the proximal convoluted tubule, the concentration of ______ is decreased.

A

most solutes

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2
Q

By how much is the concentration of filtered sodium decreased by the end of the proximal convoluted tubule?

A

66%

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3
Q

Carbonic anhydrase inhibitors, such as ______, cause sodium and bicarb to stay in the lumen leading to urine alkalization.

A

acetazolamide

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4
Q

The buildup of bicarb in the tubule _____ the pH of the urine.

A

increases

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5
Q

What does water always follow?

A

Na+

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6
Q

What is reabsorbed at the end of the proximal convoluted tubule?

A

bicarb

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7
Q

The H2O + CO2 produced by carbonic anhydrase (H2CO3) diffuse into the ______.

A

intracellular space

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8
Q

Where are Na+/K+ ATPase pumps located?

A

on the basolateral membrane

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9
Q

_____, such as acetazolamide, cause sodium and bicarb to stay in the lumen leading to urine alkalization.

A

Carbonic anhydrase inhibitors

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10
Q

What are the SEs of acetazolamide?

A
  • K+ wasting (hypokalemia)
  • type 2 renal tubular acidosis
  • increased calcium phosphate stone formation
  • they’re sulfa drugs (= hypersensitivity rxns)
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11
Q

Cue:

  • mom at the vending machine taking away peanuts and giving her son a banana
A
  • vending machine = Na+/K+ ATPase (pump) on the basolateral membrane
  • taking away peanuts = taking away Na+
  • giving banana = giving K+
  • *** The Na+/K+ ATPase pumps 3 Na+ out and 2 K+ in.
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12
Q

Cue:

  • helmets labeled “H+”
A

protons

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13
Q

Cue:

  • peanuts
A

salt (Na+)

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14
Q

Cue:

  • 3 batteries powering a banana vending machine
A
  • 3 batteries = 3 ATPs
  • banana = K+
  • vending machine = Na+/K+ ATPase (pump) on the basolateral membrane
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15
Q

What is the function of the proximal convoluted tubule?

A

reabsorption

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16
Q

Cue:

  • pro-cart track
A

proximal convoluted tubule

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17
Q

Where in the nephron does mannitol exert its effects?

A
  • in the proximal convoluted tubule
  • in the descending limb of the Loop of Henle
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18
Q

What is resorbed at the proximal convoluted tubule?

A
  • electrolytes (Na+, Cl-, K+)
  • organic solutes (glucose, amino acids)
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19
Q

Carbonic acid (H2CO3) –> ____ + ____

A

H2O + CO2

20
Q

By how much is the concentration of bicarb increased at the end of the proximal convoluted tubule?

A

85%

21
Q

Cue:

  • batteries
A

ATP

22
Q

H+ + HCO3- = ______

A

carbonic acid (H2CO3)

23
Q

Is acetazolamide K+ sparing or wasting? Why?

A
  • wasting
  • bc Na+ is spared
24
Q

Why is bicarb reabsorbed in the proximal convoluted tubule?

A

to maintain acid-base status

25
Q

What is the normal intracellular concentration of Na+ in the renal ? Why?

A
  • low
  • to allow for increased renal tubule absorption
26
Q

What kind of acid/base change do carbonic anhydrase inhibitors, such as acetazolamide, cause?

A

a normal anion gap metabolic acidosis

27
Q

Carbonic anhydrase inhibitors, such as acetazolamide, cause sodium and bicarb to stay in the lumen leading to _____.

A

urine alkalization

28
Q

How does mannitol work in the kidney?

A

it remains in the lumen –> water is pulled into the lumen towards it (osmotic diuresis)

29
Q

Cue:

  • track worker standing at the edge of the yellow/gray tracks handing out peanuts to the gray side and letting H+ helmets back into the yellow side
A
  • track worker = Na+/H+ exchanger
  • peanuts = Na+
  • H+ helmets = protons
  • *** Na+/H+ exchanger is located on the apical membrane
30
Q

By how much is the concentration of filtered glucose and amino acids decreased by the end of the proximal convoluted tubule?

A

all

31
Q

Cue:

  • bananas
A

potassium (K+)

32
Q

Which diuretics exert their effects at the proximal convoluted tubule?

A
  • acetazolamide
  • mannitol
33
Q

What is the function of the Na+/H+ exchanger?

A

allows bicarb reabsorption at the proximal convoluted tubule

34
Q

At which site in the nephron do acetazolamide and mannitol exert their effects?

A

at the proximal convoluted tubule

35
Q

What is mannitol? What is it used to treat?

A
  • an osmotic diuretic
  • tx for:
    • elevated intracranial pressure
    • elevated intraocular pressure/glaucoma
36
Q

Excessive bicarb depletion leads to _____.

A

excessive Na+/Cl- reabsorption

37
Q

The Na+/K+ ATPase pumps ____ out and _____ in.

A
  • 3 Na+ out
  • 2 K+ in
38
Q

Carbonic anhydrase inhibitors, such as acetazolamide, cause ______ to stay in the lumen leading to urine alkalization.

A

sodium and bicarb

39
Q

What are the s/s of acute mountain sickness?

A
  • weakness
  • insomnia
  • dizziness
  • HA
  • nausea
  • pulm/cerebral edema
40
Q

By how much is the concentration of potassium decreased by the end of the proximal convoluted tubule?

A

65%

41
Q

What are carbonic anhydrase inhibitors used for? Name 1 example.

A
  • tx for:
    • glaucoma (decrease aqueous humor production)
    • idiopathic intracranial HNT aka pseudotumor cerebri (decreased CSF production)
  • tx and prevention of:
    • acute mountain sickness
    • gout
    • uric acid stones/cystenuria
  • one ex: acetazolamide
42
Q

Cue:

  • yellow and gray race tracks separated by a divider
A
  • yellow = lumen of the renal tubule
  • gray = intracellular compartment of the tubule epi cells (next to the interstitium)
  • divider = basolateral membrane where Na+/K+ ATPases are located
43
Q

Cue:

  • biCARb race car on the yellow track
A
  • bicarb = HCO3-
  • yellow track = lumen of the prox. convoluted tubule (PCT)
44
Q

How does acetazolamide work?

A

it inhibits carbonic anhydrase –> no bicarb reabsorption

45
Q

This drug inhibits carbonic anhydrase –> no bicarb reabsorption.

A

acetazolamide

46
Q

What are the SEs of mannitol?

A
  • pulmonary edema
  • heart failure exacerbation
  • hypernatremia –> severe dehydration

Sketchy Pharm- CV and Renal drugs- LAH (9 decks)

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