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1. Exams - Semester 3 > Nephron > Flashcards

Nephron Flashcards

1
Q

Which part of nephron do Carbonic Anhydrides inhibitors effect?

A
  • Proximal Tubule

This is where most of the absorption occurs

  - 65% - NaCl, K, Ca, Mg
  - 85% - NaHCO3, 
  - 100% Glucose & AA
  • Secretion of Acids & Bases
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2
Q

Carbonic Anhydrides inhibitor - MOA?

A
  • Reduces Aqueous Humor production in the eye

- Inhibits enzymes responsible for dehydration of H2CO3

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3
Q

Carbonic Anhydrides inhibitor drugs?

A
  • Acetazolamide –> Altitude sickness
  • Dorzolamide (topical) –> Glaucoma
  • Brinzolamide (topical) –> Glaucoma
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4
Q

Carbonic Anhydrides inhibitor - Uses?

A
  • **GLAUCOMA
  • Urinary alkalization,
  • Metabolic alkalosis,
  • Acute mountain sickness

Can cause (incr pH)

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5
Q

Carbonic Anhydrides inhibitor - ADRs?

A
  • Stones,
  • K wasting,
  • Drowsiness,
  • Hypersensitivity
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6
Q

Carbonic Anhydrides inhibitor - CI?

A

Hepatic cirrhosis

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7
Q

Loop diuretics drugs?

A
  • Furosemide - 40
  • Toresemide - 20
  • Bumetanide - 1
  • Ethacrynic Acid (Edercin)
    - Safe in pts w/ sulfa allergy
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8
Q

Loops MOA?

A

Inhibits Na, K & Cl transport/pump

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9
Q

Loops uses?

A
  • Edema,
  • CHF
  • ↑ Ca
  • ↑ K
  • Anion overdose
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10
Q

What drug can effect loops and how?

A

NSAIDS reduce the effect of loops

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11
Q

LOOP - CI?

A
  • Sulfa allergy (Ethacrynic Acid is safe to use)

- overuse in HF, Cirrhosis, RF

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12
Q

Loop - ADRs?

A
  • ↓ Mg
  • ↑ Uric acid
  • Ototoxicity
  • Hypersensitivity
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13
Q

Role of Loop of henle?

A
  • Reabsorbs 15-25% of
    - NaCl, K, Ca, Mg,
  • Secretes
    - K
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14
Q

Loop conversion of Furosemide?

A

PO - IV –> 2:1

Ceiling effect can occur

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15
Q

Which part of nephron do Thiazides effect?

A

DCT

DCT role:
Reabsorbs 4-8% of:
- Na, Cl

Secretes
- Ca (ctrl’ed by parathyroids)

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16
Q

Thiazides - drugs?

A
  • HCTZ (Hydrodiuril)

- Chlorothiazide (Diuril)

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17
Q

Thiazides - MOA?

A
  • Inhibit NaCl transporter
  • Enhance Ca reabsorption
  • Slow absorption
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18
Q

Thiazides - Uses?

A
  • **HTN (MC)
  • HF
  • DM,
  • Nephrolithiasis
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19
Q

Thiazides - ADRs?

A
  • ↓ Na
  • ↓ K
  • ↑ Uric acid
  • ↑ lipids
  • Photosensitivity
  • Hypersensitivity
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20
Q

Thiazides - CI?

A
  • *Overuse in
    • HF
    • Cirrhosis
    • RF, *****GFR< 20
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21
Q

Thiazides-like diuretic drugs?

A
  • Metolazone (Zaroxylin)
  • Indapamide (Lozol)
  • Chlorthalidone IV
22
Q

Thiazides-like diuretic - MOA?

A

Works same as Thiazides (d/t sulfa group they contain), but structurally different

23
Q

What’s unique about Metolazone?

A

Can be used in ***GFR <20

24
Q

Which Thiazides-like diuretic has slowest absorption?

A

Chlorthalidone IV

- has long 1/2 life***

25
Q

Thiazides-like diuretic ADRs & CI?

A

SAME as Thiazides

26
Q

At what level of GFR are thiazides ineffective?

A

*****GFR < 20

  • Except Metolazone
27
Q

What is the only Thiazide-like diuretic on IV formulation?

A

Chlorthalidone

28
Q

Which part of nephron do K Sparing work on?

A

Cortical Collecting Tubule

Cortical Collecting Tubule role:

  • Reabsorbs 2-5%
    - Na
  • Secretes
    - H & K
29
Q

K Sparing - Drugs?

A
  • Spironolactone
  • Eplerenone (DI: Fluconazole, diltiazem, ****GF juice)
  • Triamterine
  • Amiloride
30
Q

K Sparing - MOA?

A

Spironolacton & Eplerenone:

  - Prevents K secretion
  - Antagonizes mineralocorticoid receptors
   - Prevents aldosterone from binding

Triamterine & Amiloride
- Inhibits Na ion channels

31
Q

K Sparing - Uses?

A
  • ***Hypokalemia

- For prevention & tx

32
Q

Spironolacton uses?

A
  • Hyperaldosterone,
  • PCOS,
  • Hirsutism.
    • *Slow onset (days)
33
Q

Spironolacton ADR & CI?

A

ADR:

  • Gynecomastia,
  • Impotence.

CI:
- Addison’s

34
Q

What MUST you ALWAYS check before giving K Sparing?

A

***K levels,

  • bc K-sparing can cause **Hyperkalemia
35
Q

Triamterine ADR?

A

Kidney Stones

36
Q

Which part of the nephrons does ADH (aka vasopressin) Antagonist effect?

A

Medullary collecting duct

Medullary duct role:

  • Reabsorbs:
    - *H2O
  • Secretes
    • Nothing
37
Q

ADH Antagonist - drugs?

A

Indirect:

  • Lithium,
  • Demeclocycline

Direct (DI: Fluconazole, diltiazem, ***GF juice):

  • Conivaptan,
  • Talvaptan
38
Q

ADH Antagonist - MOA (indirect)

A

Unknown

39
Q

ADH Antagonist - MOA (direct)

A
  • Inhibits vasopressin receptors

- Direct binding

40
Q

ADH Antagonist - Uses?

A
  • ***CHF
  • ***SIADH

Onset - hrs

41
Q

ADH Antagonist - ADRs (Direct)

A
  • Nausea,
  • Dry mouth,
  • Thirst
42
Q

ADH Antagonist - CI (Direct)

A
  • Hypovolemia

- Hyponatremia

43
Q

ADH Antagonist (direct)- drug-drug interaction?

A
  • Strong CYP 3A4
  • Fluconazole
  • Diltiazem
  • ***GF juice
44
Q

Osmotic Diuretic - Drugs?

A
  • Glycerol
  • Mannitol (PO, Inhale, IV)
    • IV formulation crystalized - keep it worm
45
Q

Osmotic Diuretic - MOA?

A
  • ↑ Osmotic pressure in Glomerulus,
  • ↓ reabsorption of H2O & lytes
  • Work outside of the nephron
46
Q

Osmotic Diuretic - Uses?

A
  • *Cerebral edema,
  • *Acute glaucoma,
  • Bronchial hyper-responsiveness.
47
Q

What is the problem with Osmotic Diuretics absorption?

A
  • ***Poor absorbed & quick excreted

- Oral better tolerated (mix w/ OJ to help pt tolerate it better)

48
Q

Glycerol ADRs?

A

N/V/D

49
Q

Mannitol ADRs?

A
  • **Excess volume expansion
  • HF
  • Edema
  • Pulm congestion
50
Q

Osmotic Diuretic - CI?

A

Hypersensitivity

1. Exams - Semester 3 (21 decks)

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