Drugs with Therapeutic Effects on Renal Function Flashcards
what do diuretic do
increase excretion of sodium and chloride ions and water from the renal tubules
this increases urinary flow
indications of diuretics
conditions where there is excess accumulation of water and sodium in the body
e.g. heart failure, liver failure, renal failure, hypertesion
what are the five types of diuretic
loop
thiazide and thiazide type
potassium sparing
osmotic
carbonic anhydrase inhibitor
2 examples of loop diuretics
furosemide
bumetanide
where do loop diuretics act
thick ascending limb of LoH
give 2 examples of thiazide/-type diuretics
bendroflumethiazide, chlortalidone
where do thiazide diuretics work
DCT
give 2 examples of potassium sparing diuretics
sprionolactone
amiloride
what is the MoA of potassium sparing diuretics
inhibit reabsorption of 2-3% of sodium ions in exchange for potassium or hydrogen ions in
when are osmotic diuretics used
to treat cerebral oedema in intensive care occasionally
example of osmotic diuretic
mannitol
MoA of osmotic diuretic
filtered at glomerulus
not reabsorbed
so exert osmotic pressure
which prevents water reabsorbtion
name of carbonic anhydrase inhibitor
acetazolamide
indications of acetazolamide
prevent acute altitude sickness
glaucoma management
occasionally as mild diuretic
MoA of acetazolamide
reduces production of hydrogen and bicarbonate ions which are necessary for a proportion of reabsorption of soidum and chloride ions in the PCT
difference in MoA of ACEi vs. ARBs
ACEi - inhibit production of angiotensin II
ARB - block action of angiotensin II at its receptor
indications and contraindication of ARBs and ACEis
hypertension and heart failure
not primary renal disease
what drugs act on the PCT
SLGT-2 inhibitors
uricosuric drugs
MoA of SLGT-2 inhibitors
inhibits co-transporter that reabsorbs glucose with sodium which increases urinary excretion of glucose
indication of SLGT-2 inhibitors
type 2 diabetes
indications of uricosuric drugs
long term prevention of gout
MoA of uricosuric drugs
block reabsorption of uric acid in PCT
where does synthetic parathyroid hormone act
DCT
indication of synthetic PTH
to maintain reabsorption and calcium concentration in patients with chronic hypoparathyroidism
what drugs act on the collecting duct
vasopressin analogues and inhibitors
name of vasopressin analogue
desmopressin
indication of desmopressin
diabetes insipidus - those who can’t make vasopressin so become dehydrated
indication of vasopressin inhibitors
excessive secretion of vasopressin due to tumour or drugs - SIADH
what is demeclocycline and what is its MoA
an antibiotic which inhibits the responsiveness of the collecting duct cells to vasopressin and reduces water reabsorption when fluid restriction alone has been ineffective
what is tolvaptan and its MoA
vasopressin V2 receptor antagonist which reduces water reabsorption
what are epoetins
recombinant human erythropoetins
indication of epoetins
used to treat anaemia associated with erythropoetin difficeincy in chronic renal failure
indication of hydroxylated forms of vitamin D (alfacalcidol and calcitriol)
severe renal impairment where the kidneys can’t hydroxylate vitamin D themsleves
indication of sodium bicarbonate
those with advanced renal impairment who develop metabolic acidosis as they are not reabsorbing sodium bicarbonate in their PCTs
