Kidneys

Question 1

What is a nephrons role and what is t made up of

Answer 1

Filtration.

Glomerolous, proximinal tubule, descending loop of gentle, ascending loop of henle, distal tubule, collecting duct.

Question 2

What are diuretics and what do they treat

Answer 2

Drugs which increase water secreted by the kidneys

Treat oedema, hypertension, glycoma

Question 3

What is oedema

Answer 3

Excess fluid around the tissues

Question 4

How do diuretics treat hypertension

Answer 4

By increasing urine volume produced, decreasing blood volume, which decreases pressure on blood vessels, which decreased blood pressure.

Question 5

What are the three ways of sodium and water moving

Answer 5

Pumps
Channels
Osmosis

Question 6

What are the three pumps on the nephron

Answer 6

Sodium potassium pump
Sodium chloride pump
Sodium potassium chloride pump

Question 7

How do channels work

Answer 7

They open at the membrane and are ion selective. No energy required

Question 8

How does osmosis work

Answer 8

Sodium leaves and water follows

Question 9

What are the tree classes of diuretics

Answer 9

Thiazides
Loop diuretics
Potassium sparing diuretics

Question 10

Where do thiazides work

Answer 10

Distal convoluted tubule

Question 11

What do thiazides treat

Answer 11

Oedema
Mild heart failure. Liver and kidney disease. Steroid or hormone problems.
Hypertension that is long term

Question 12

What is an example of a thiazide

Answer 12

Bendrofluerthazide

Question 13

What is an example of a related thiazide

Answer 13

Metolazone

Question 14

How do thiazides work

Answer 14

They block the chloride pump on the apical membrane.
Increase sodium and chloride excretion and water follows.
Increase potassium excretion.

Question 15

Nursing points in thiazides

Answer 15

Moderate potency
Urine flow increased 1-3ml/min
Work up to 24hr so take in morning
Work within 1-2 HR

Question 16

What are the side effects of thiazides

Answer 16

Hypokalemia
Hypocalcaemia
Hyperurlcemia
Hyperglycaemia

Question 17

Where to loop diuretics take action

Answer 17

Ascending loop of henle

Question 18

What do loop diuretics treat

Answer 18

Oedema
Severe heart failure
Acute ventricular failure
Hypertension in the short term

Question 19

What is an example of a loop diuretic

Answer 19

Furosemide

Question 20

What action do loop diuretics take

Answer 20

Block chloride, sodium, poitassium pump
This increased sodium chloride potassium excretion
There is a build up of sodium chloride potassium In the lumen.

Question 21

What are key points about loop diuretics

Answer 21

Very powerful
Very potent
Increases grime output 1-8ml/min
Take twice day (before 4 afternoon)

Question 22

What are the side effects of loop diuretics

Answer 22

Hypokalemia
Hypocalcaemia
Hyperglycaemia
Hyperuricemia
Deafness when given high dose

Question 23

Where do potassium paring diuretics work

Answer 23

Distal convoluted tubule/ collecting ducts

Question 24

What do potassium sparing diuretics treat

Answer 24

Oedema heart failure liver disease
Hypertension
Hypokalemia

Primary hyperaldoesteronism (spironolactone)

Question 25

What are three potassium | Sparing diuretics

Answer 25

Spironolactone (aldosterone antagonist) | Amiloride/ trianeterene (sodium channel blockers)

Question 26

How do potassium sparing diuretics work

Answer 26

Increase sodium and water secretion As well we chloride and calcium They decrease potassium and hydrogen secretion

Question 27

What are notes to remember about potassium sparing diuretics

Answer 27

Weak diuretics Need close monitoring of electrolyte balance ( when n ace inhibitors, b receptor antagonists)

Question 28

What are he side effects of potassium sparing diuretics

Answer 28

Hyperkalemia (need low pot diet)

Question 29

What are anti diuretics

Answer 29

Decrease water output

Question 30

Where do antidiuretics work

Answer 30

In the collecting tubule

Question 31

What do anti diuretics treat

Answer 31

Central diabetes inspidus (lack ADH)

Question 32

What are two anti diuretic drugs

Answer 32

Vasopressin (ADH) | Desmopressin

Question 33

How do anti diuretics work

Answer 33

Realised in posterior pituitary Increase water channels via V2 receptors Increase passive reabsorption of water , increased number of channels which let water in.

Question 34

What are notes to remember about anti diuretics

Answer 34

``` VASOPRESSIN short duration action Increases BP Injected or infused DESMOPRESSIN Longer duration Nasal spray or tablet Only works on V2 receptors so no effect on BP ```

Question 35

8 points to remember about diuretics

Answer 35

``` . Look at patient history . Administer in the morning . Check urine output and weight . Check odema/ congestion . Check BP . Check for hypotension or dizziness . Diet low in potassium and sodium . Monitor serum electrolytes ```

Question 36

What is the kidneys role within the body

Answer 36

To manage salts and fluid within the body