Drugs Used In Renal and Urinary Tract Disorders Flashcards
What is the urinary system composed of?
2 kidneys, 2 ureters, urinary bladder, urethra
What is the trigone of the bladder?
2 ureters and 1 urethra
What is the Hilus?
Indented medial side of the kidney where the ureters, nerves, blocks, and lymph vessels enter and leave
What are some functions of the urinary system?
- To maintain homeostasis by: filtration, reabsorption, and secretion
- Production of hormones
- Blood volume control
- BP regulation
- Filters toxins in blood (mainly urea)
What is micturition?
Expulsion of urine from the urinary bladder into the urethra
What is the job of the nephron?
To regulate water and soluble matter (especially electrolytes) in the body
True or False
Nephrons dont regenerate
True
______ have large fenestrations in capillary endothelium (single layer)
Glomerular capillaires
____ BP in glomerular capallaries force some plasma out and into the space of the _________
High
Bowmans Capsule
What is glomerular filtration rate (GFR)?
How fast plasma is filtered through the glomerulus
About 65% of reabsorption occurs in the ____ (water, Na, Cl, K, Ca, Bicarb, and 100% glucose amino acids)
Proximal convoluted tubule
What are some important substances that are secreted out of the kidney are?
Hydrogen, potassium, and ammonia
Collecting ducts are the are also the site of _________ action which prevents dehydration
Antidiuretic Hormone (ADH)
Impaired renal excretion of biotransformation causes delayed elimination of many drugs and enhances their ___ and ___ of action.
Toxicity
Duration
True or False
The presence of abnormal amounts of protein in the urine is used as an indicator of glomerular damage
True
What is the definition of renal threshold of glucose?
When the blood glucose level gets too high, the amount of glucose filtered through the glomerulus exceeds the amount that can be reabsorbed and lost in the urine
What are the 2 hormones that are responsible for the majority of urine volume regulation?
- Antidiuretic Hormone (ADH)
- Aldosterone
What hormone acts on the DCT and collecting ducts to promote water reabsorption?
ADH
True or False
ADH prevents water loss from the body, and regulates fluid balance.
True
Which hormone when working properly is the body’s fail safe mechanism so that we dont dehydrate if we lack of fluid intake?
ADH
Which hormone is secreted by the posterior pituitary gland?
ADH
True or False
If the posterior pituitary gland is not releasing adequate amounts of ADH, water is not being secreted.
False
Reabsorbed
Which hormone of the bladder is one of the factors when diagnosing diabetes insipidus?
ADH
True or False
Aldosterone decreases reabsorption of Na in DCT and collecting ducts back into the blood
False
Increases
What causes an osmotic imbalance which causes water to flow back into the blood along with the sodium?
Aldosterone
What is the definition of renal dysfunction?
Any pathological condition that results in th inability of the urine system to adequately remove waste materials from the blood
True or False
Waste materials build up in the blood and become toxic to the pet and the resulting condition is called urea
False
Uremia
What is the definition of Uremia?
Abnormally high concentrations of urea, creatinine, and other nitrogenous end products of protein and amino acid metabolism in the blood
True or False
Uremia can increase the sensitivity of some tissues to certain drugs
True
Which drugs can be contraindicated in uremic patients?
Xylazine and Ketamine
What is erythropoiesis?
Formation of erythrocytes
What is a hormone that is secreted by a healthy kidney that communicates with the bone marrow to make more RBC
Erythropoietin
In diseased kidneys, what hormone is secreted in reduced amounts or not at all resulting in normocytic, normochromic, nonregenerative anemia?
Erythropoietin
What human recombinant erythropoietin may be given to animals to treat nonregenerative anemia, but is considered the “last ditch effort”?
Epogen
What is the definition of diuretic drugs?
Used to remove excess extracellular fluid by increasing urine flow (diuresis) and Na excretion and reducing hypertension
What diuretic inhibits tubular reabsorption of Na at the loop of henle and makes tremendous diuresis?
Loop
What diuretc is fast acting, given IV and promotes the excretion of Cl, K and water?
Loop
What are some clinical uses of Loop Diuretics?
Treats CHF, pulmonary edema, hypercalcemic nephropathy and uremia
What is an example of a loop diuretic?
Furosemide (Lasix)
What are some side effects of Loop Diuretics?
Hypokalemia because of the increased excretion of K, so patients may have to be put on a potassium supplement
What is an example of osmotic diuretics?
Glucose and mannitol
Which diuretic drug treats oliguric acute renal failure and reduce intracranial and intraoccular pressure?
Osmotic
What are some side effects of osmotic diuretics?
Electrolyte imbalances and vomiting
What is an example of a thiazide diuretic?
Hydrochlorothiazide
How do thiazide diuretics work?
By reducing edema by inhibiting reabsorption of Na, Cl, water at renal tubules
True or False
Thiazide diuretics have a longer action than that of Loop diuretics?
True
Which diuretics can cross the placental border?
Thiazide
What are some clinical uses of Thiazide diuretics?
Nephrogenic diabetes insipidus and hypertension
What are some side effects of Thiazide diuretics?
Hypokalemia if therapy is prolonged and cardiac dysfunction
What is an example of Potassium-Sparing Diuretics?
Spironlactone
Which diuretic is a weaker diuretic and has antihypertensive effects, but do conserve potassium?
Potassium Sparing
True or False
Potassium Sparing cannot be used with other diuretics
False
They can mainly Loop
Which diuretic blocks the action of carbonic anhydrase, which is used by the body to maintain acid-base balance
Carbonic Anhydrase Inhibitors
What is an example of a Carbonic Anhydrase Inhibitor?
Acetazolamide
True or False
Carbonic Anhydrase Inhibitors reduce intraoccular pressure by reducing the production of aqueous humor and may be used to treat glaucoma
True
What are some side effects of Carbonic Anhydrase Inhibitors?
Hypokalemia, metabolic acidosis (tachypena, twitching, mouth ulcers, weight loss , and muscle loss)
What is the definition of urinary incontinence?
The loss of voluntary control of micturition
What are some examples of neurologic urinary incontinence?
Trauma to the spinal cord, turmors of the NS
What are some examples of non-neurologic urinary incontinence?
Neoplasia, trauma to the bladder and stress
What is an example of Cholinergic Agonsit drug?
Bethanechol
Cholinergic agonists help void the bladder by _______, Anticholinergic agents urge incontinence by ______ retention of the bladder
Expulsion
Retention
True or False
Cholinergic agonists promote function of ACH
True
What is detrusor muscle?
Muscular layer of the urinary bladder wall
What are some side effects of Cholinergic agonists?
Toxicity
Do not use of the integrity of the bladder is unknown
What is an example of Anticholinergic agents?
Propantheline
What are the 2 kinds of adrenergic antagonists?
- Alpha adrenergic antagonists
- Beta adrenergic antagonists
What is an example of alpha adrenergic antagonist?
Prazosin, Phenoxybenzamine
Which adrenergic antagonist is useful when treating urinary retention cause of detrusor areflexia (absense of detrusor contractions) or functional urethral obstruction?
Alpha
What is a side effect of Alpha adrenergic antagonist?
Rapid decrease in BP resulting in weakness or syncope after the first dose
What is an example of Beta adrenergic antagonist?
Propanolol
Which adrenergic antagonist inhibits the action of catecholamines and inhibit the stimulation of the sympathetic NS?
Beta
What is Beta adrenergic antagonist used to control?
Mild to moderate hypertension associated with CRF
True or False
When blood volume is low, kidneys secrete renin directly into circulation
True
How does angiotension 1 convert to angiotension 2?
ACE (Angiotension converting enzyme)
What are some examples of ACE inhibitors?
Benazepril, captopril, enalapril
What may be substituted for or used in combination with other meds if previous drug therapy to control hypertension fails?
Vasodilatros and calcium channel blockers
What is an example of a vasodilator?
Dopamine
What is an example of calcium channel blocker?
Diltiazem and amlodipine
What is an example of a urinary acidifier?
Methigel
True or False
Urinary acidifiers assist in dissolving and preventing formation of struvite uroliths
True
What is an example of urinary alkalizers?
Potassium citrate, sodium bicarbonate
True or False
Urinary Alkalizers are easily dissolved in calcium oxalate crystals without altering calcium metabolism in the body
False
Difficult to dissolve
What is an example of Xanthine Oxidase Inhibitor?
Allopurinol
What urolith treatment helps dalmations and paitents with gout?
Xanthine Oxidase Inhibitors
What are found covering the transitional epithelium of the urinary tract?
GAGs
What keeps microrganisms and crystals from adhering to the bladder wall?
GAGs
True or False
Defects in surface GAGs are velieved to be a factor in FLUTD
True
True or False
Cranberry juice, crananidin makes the bladder wall slippery so bacteria doesnt stick
True
What claims the potential to reduce azotemia through enteric dialysis
Azodyl
What dog breeds are predisposed to developing bladder stones?
Dalmations and miniture schnauzers
