Diuretics (Lecture 12) Flashcards

1
Q

What is the overall effect that a diuretic will have and its mechanism of action?

A
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2
Q
A
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3
Q

What is the main way that Na+ is reabsorbed (at a certain cell in the nephron)?

A
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4
Q

What is the osmotic diuretic which we need to know?

How does it work?

Where in the kidney does it act the most?

A

Mannitol.

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5
Q

What are the theraputic uses of mannitol?

What are the toxic side effects?

A

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.

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6
Q

Which diuretic works on the thick ascending loop of Henle (loop diuretic)?

A

Furosemide.

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7
Q

How does furosemide work?

A
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8
Q

Explain the image.

A

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.

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9
Q

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.

A

Na+ and Cl-, H+ and K+.

Na+/K+ exchangers.

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10
Q
A
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11
Q

What are the therapeutic uses of loop diuretics?

A
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12
Q

Side effects of loop diuretics?

A
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13
Q

Distal tubule diuretic, effectiveness and the example which we need to know?

A

Bendroflumethiazide

NCC1 is a co-transporter therefore Na+ and Cl- are not reabsorbed.

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14
Q

What conditions is a thiazide used (distal tubule diuretic)?

A
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15
Q

What are the adverse side effects of thiazides?

A

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)

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16
Q

Explain the effect that aldosterone has on the kidneys and on blood pressure?

A

Sodium is kept at the expense of potassium.

17
Q

What is the K+ sparing diuretics which we need to know?

A

Spironolactone (aldosterone effecting) and amiloride.

18
Q

How does spironolactone work?

The higher the levels of ________ the greater the effect.

A

Aldosterone, the greater the effect.

19
Q

What are the toxicities of spironolactone?

A
20
Q

How does amiloride work?

What drug is it often used in conjunction with?

A

Used in conjunction with thiazides to limit the K+ loss but increase the Na+ loss.

21
Q

Main uses of K+ sparing diuretics?

A
22
Q
A
23
Q

All diuretics but _________ have their affect on the ______ side of the nephron.

A

spironolactone have their effect on the luminal side of the nephron.

24
Q

All diuretics are used to treat ____________ and _________ is also used to treat hypertension.

A

oedema, thiazides (bendroflumethiazide).