Diuretics (Lecture 12) Flashcards
What is the overall effect that a diuretic will have and its mechanism of action?
What is the main way that Na+ is reabsorbed (at a certain cell in the nephron)?
What is the osmotic diuretic which we need to know?
How does it work?
Where in the kidney does it act the most?
Mannitol.
What are the theraputic uses of mannitol?
What are the toxic side effects?
Used for someone with increased intraocular pressure or intracranial pressure.
Toxic effects: it pulls water from the extracellular space and ‘creates’ more blood, this means that if someone is in left heart failure then it will cause even worse pulmonary congestion.
Which diuretic works on the thick ascending loop of Henle (loop diuretic)?
Furosemide.
How does furosemide work?
Explain the image.
Loop diuretics which disrupt the NKCC2 transporter mean that other cations like Na2+, Ca2+ and Mg2+ are not reabsorbed due to disruption of the -10mV transepithelial difference.
Loop diuretics profoundly increase urinary ___ and ____ excretion. Presentation of high loads of these ions causes increase loss of ___ and ___ at the distal and collecting ducts.
This is because of the ______ transporter at the collecting ducts.
Na+ and Cl-, H+ and K+.
Na+/K+ exchangers.
What are the therapeutic uses of loop diuretics?
Side effects of loop diuretics?
Distal tubule diuretic, effectiveness and the example which we need to know?
Bendroflumethiazide
NCC1 is a co-transporter therefore Na+ and Cl- are not reabsorbed.
What conditions is a thiazide used (distal tubule diuretic)?
What are the adverse side effects of thiazides?
Adverse side effects #2: K+ loss will prolong the QT interval, particularly in association with other QT extenders therefore could cause ventricular fibrillation (torsade de pointes)
Explain the effect that aldosterone has on the kidneys and on blood pressure?
Sodium is kept at the expense of potassium.
What is the K+ sparing diuretics which we need to know?
Spironolactone (aldosterone effecting) and amiloride.
How does spironolactone work?
The higher the levels of ________ the greater the effect.
Aldosterone, the greater the effect.
What are the toxicities of spironolactone?
How does amiloride work?
What drug is it often used in conjunction with?
Used in conjunction with thiazides to limit the K+ loss but increase the Na+ loss.
Main uses of K+ sparing diuretics?
All diuretics but _________ have their affect on the ______ side of the nephron.
spironolactone have their effect on the luminal side of the nephron.
All diuretics are used to treat ____________ and _________ is also used to treat hypertension.
oedema, thiazides (bendroflumethiazide).
