Diuretics & Electrolytes Flashcards
diuretic due to blockade of carbonic anhydrase, principal uses include urinary alkalinization, treatment of metabolic alkalosis, acute mountain sickness and glaucoma
acetazolamide
causes hyperkalemia until that excess plasma K+ is excreted, and then hypokalemia is a possibility
acidosis
when Fanconi syndrome is caused by multiple myeloma or nephrotic syndrome, for example, the condition is characterized as being ______
acquired
aka vasopressin, released by posterior pituitary, plasma levels of this are not normally affected by blood volume, but go up dramatically (e.g., higher than seen with osmolality changes) when effective plasma volume is more than 10% below its set point
ADH
5% solution could be infused to try to expand the plasma volume; low levels of this in plasma decrease total Ca2+ without decreasing ionized Ca2+ (so need to calculate this value)
albumin
adrenal hormone that promotes K+ excretion with Na+ retention; low levels during hypokalemia act to keep K+ from entering cells while high levels during hyperkalemia facilitate the exit of excess K+ from cells for renal elimination
aldosterone
administration corrects plasma K+ levels in type 1 RTA, can worsen them in type 2 RTA if it ends up in urine
alkali
a diuretic that blocks epithelial sodium channels (EnaC) in the principal cells of the collecting ducts
amiloride
potent vasoconstrictor and sodium retaining hormone due to direct effects in kidney, its selective efferent constriction helps maintain GFR as renal perfusion pressure falls, also stimulates aldosterone secretion
angiotensin II
electroneutrality principle states that there must be one of these for every cation in a compartment; the charge separated when combination of concentration difference and permeabilities means that one of the particles would prefer to be in another compartment is what gives rise to membrane and transepithelial potential differences (voltages)
anion
abbr., released from the heart by overfilling, acts in the kidney to increase GFR and decrease Na reabsorption (= increase Na excretion) to cause a decrease in effective plasma volume
ANP
substance that promotes free water clearance
aquaretic
occurs in liver disease due to impaired synthesis of plasma proteins and increased portal venous pressure
ascites
occurs in kidney at least in part by tubuloglomerular feedback and myogenic mechanism, means that GFR and RBF are approximately constant over a mean arterial pressure range of ~90 to 150 mm Hg
autoregulation
syndrome with effects similar to a loop diuretic… urinary loss of Na+, K+, Ca2+, Mg2+, hypochloremic metabolic alkalosis, inability to concentrate or dilute urine
Bartter
contains most of the Ca2+ and phosphate in the body and ~half of the Mg2+
bone
surprising consequence of hyperkalemia, occurs because hyperkalemia increases K+ conductance in SA nodal tissue enough to cause membrane hyperpolarization; other regions of heart do become hyperexcitable so arrhythmias likely
bradycardia
swelling of this organ by rapid onset hyponatremia or too-rapid correction of chronic hypernatremia can have catastrophic consequences
brain
a loop diuretic with similar adverse effects as furosemide but a more predictable oral absorption, doesn’t end in “semide”
bumetanide
expression is increased in DCT by calcitriol, needed for transcellular movement of large amounts of Ca2+ without causing apoptosis
calbindin
calcium regulatory hormone often ignored, it promotes excretion of both Ca2+ and PO4—
calcitonin
1,25 OH vitamin D3, the biologically active form that promotes intestinal absorption of Ca2+ and PO4— and the breakdown of bone to release Ca2+ and PO4—
calcitriol
administered IV to quickly antagonize cardiac effects of hyperkalemia (raises the action potential threshold)
calcium
a cause of real hyperkalemia and pseudohyperkalemia (2 words)
cell lysis