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Sketchy Pharm- CV and Renal drugs- LAH > Diuretics: Ch.2-4: Potassium sparing drugs > Flashcards

Diuretics: Ch.2-4: Potassium sparing drugs Flashcards

1
Q

What is a principal cell?

A

the site of Na/K/H2O transport in the collecting duct

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2
Q

About how much NaCl is reabsorbed in the collecting duct?

A

5-10%

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3
Q

What is the function of the alpha-intercalated cell of the collecting duct?

A

it’s the major site of H+ secretion

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4
Q

What channel is responsible for Na+ reabsorption in the collecting duct?

A

ENaC (epithelial Na+ channels)

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5
Q

This is a K+-sparing diuretic that is a competitive aldosterone receptor antagonist in the collecting duct.

A
  • eplerenone
  • spironolactone
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6
Q

What is eplerenone? How does it work? What is it used to treat?

A
  • a K+-sparing diuretic
  • a competitive aldosterone receptor antagonist (specific)
  • tx for:
    • hyperaldosteronism
    • K+ depletion
    • HF
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7
Q

Dx?

  • overactive ENaC –> increased Na+ resorption in the collecting tubules –> hypokalemia, metabolic alkalosis, and HTN but low aldosterone
A

Liddle Syndrome

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8
Q

What are the SEs of amiloride and triamterene?

A

hyperkalemia –> arrhythmias

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9
Q

Why is spironolactone anti-androgenic?

A
  • it prevents testosterone synthesis by blocking 17-alpha-hydroxylase
  • blocks the androgen receptor
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10
Q

Aldosterone works at the _____ of the nephron, promoting Na+ reabsorption and water retention.

A

collecting duct

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11
Q

Which part of the nephron is most important for K+ regulation?

A

the collecting duct

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12
Q

This is the site of Na/K/H2O transport in the collecting duct.

A

the principal cells

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13
Q

What is the major site of H+ secretion in the collecting duct?

A

the alpha-intercalated cell

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14
Q

Aldosterone binds to _____ receptors.

A

intracellular

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15
Q

______ works at the collecting duct, promoting Na+ reabsorption and water retention.

A

Aldosterone

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16
Q

Aldosterone increased gene transcription to cause ____.

A

increased # of channels in the collecting duct

17
Q

What causes Liddle Syndrome?

A

it’s an auto dominant gain of function mutation

18
Q

What is the tx for Liddle Syndrome?

A
  • amiloride
  • triamterene
19
Q

Where does aldosterone exert its action?

A

the collecting duct

20
Q

What is Liddle Syndrome?

A

overactive ENaC –> increased Na+ resorption in the collecting tubules –> hypokalemia, metabolic alkalosis, and HTN but low aldosterone

21
Q

What is the main job of a K+-sparing diuretic?

A
  • to antagonize the effects of aldosterone or ENaC
22
Q

What are the SEs of spironolactone?

A
  • normal anion gap metabolic acidosis
  • gynecomastia
  • anti-androgen
  • impotence
  • decreased libido
23
Q

Why do spironolactone and eplerenone reduce morbidity and improve mortality in HF patients?

A

they reduce myocardial remodeling induced by high levels of aldosterone

24
Q

What is spironolactone? How does it work? What is it used to treat?

A
  • a K+-sparing diuretic
  • a competitive aldosterone receptor antagonist (nonspecific)
  • tx for:
    • ascites
    • hyperaldosteronism
    • K+ depletion
    • HF
    • PCOS
25
Q

The potassium-sparing diuretics act upon the _____.

A

collecting duct

26
Q

Aldosterone works at the collecting duct, promoting ____ reabsorption and _____ retention.

A

Na+; water

27
Q

This is a K+-sparing diuretic that blocks Na+ reabsorption thru ENaC and is a tx for Liddle Syndrome and nephrogenic DI.

A

amiloride

28
Q

What are the potassium sparing diuretics?

A

thiazides

29
Q

What is triamterene? How does it work? What is it used to treat?

A
  • a K+-sparing diuretic
  • blocks Na+ reabsorption thru ENaC
  • tx for:
    • Liddle Syndrome
    • hyperaldosteronism
    • K+ depletion
    • HF
30
Q

In a normal kidney, why is so much K+ wasted at the collecting duct?

A

because Na+ is resorbed and NOT exchanged (ENaC)

31
Q

What is amiloride? How does it work? What is it used to treat?

A
  • a K+-sparing diuretic
  • blocks Na+ reabsorption thru ENaC
  • tx fo:
    • Liddle Syndrome
    • nephrogenic DI (from lithium)
    • hyperaldosteronism
    • K+ depletion
    • HF

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

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