Nyre Flashcards

1
Q

Behandling af:

Urinsyregigt

A

Lægemidler:

  • Allopurinol
  • Probenecid
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2
Q

Mekanisme:

Allopurinol

A

Allopurinol: Hæmmer syntesen af urinsyre

  • øger allo-xanthines virkning via xanthine oxidase
  • xanthine oxidase hæmmer omdannelse af;
  • hypo-xanthine til xanthine
  • og xanthine til urinsyre
  • > minus uratkrystaller (ledgigt)
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3
Q

Mekanise:

Probenecid

A

Proximale tubili:
- Hæmmer urat/affaldsstoffer (herunder LM) udvekslings
- urat udskilles fra kroppen
F.eks. for at øge penicillins effekt

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4
Q

Anatomi af:

Urin systemet

A
  • Nyre
  • Urinlede
  • Blæren
  • Urinrør
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5
Q

Anatomi af:

Nyren

A
  • Urinleder
  • Medulla
  • Cortex
  • Nephroner
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6
Q

Anatomi af:

Nephron

A
  • Bowman’s capsule
  • Proximal tubule
  • descending og ascending part of loop og Henle
  • Distal tubule
  • Samle tuberne
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7
Q

I hvilke område blodtrykket ikke GFR?

A

Normalt blodtryk; 80-180 mmHg -> GFR=180 L/døgn

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8
Q

Brug af:
PAH
(para-aminohippuric acid)

A

= RPF (renal plasma flow)

- filteret PAH er lig det PAH der er i blodet

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9
Q

Transport i:

Proximal tubule

A

Reabsorption og Secretion:

  • Antiport: Na+ reabsorption, H+ secretion
  • Reabsorption: H2O + CO2 -> HCO3-
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10
Q

Transport i:

Descending part of loop of Henle (nedadgående)

A

Reabsorption

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11
Q

Transport i:

Ascending loop part of of Henle (opadgående)

A

Reabsorption:

Tripel-symporter: Na+, K+, 2Cl-

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12
Q

Transport i:

Distal tubule

A

Reabsorption og Secretion:
Na+/K+: reabs: Na+, secre: K+
Vand: reabs: H2O, CO2, secre: H+

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13
Q

Transport i:

Samle tuberne

A

Reabsorption og Secretion:
Na+/K+: reabs: Na+, secre: K+
Vand: reabs: H2O, CO2, secre: H+

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14
Q

Virkningsområder:

Nephron

A

Bowmans: osmotiske diuretika
Ascending: loop diuretika
Distal: Thiazier
Samle: Amiloride, spironolactone

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15
Q

Mekanisme:

Loop diuretika

A

Virker i: ascending loop

  • Hæmmer reabsorptionen af ioner (Na, K, 2Cl)
  • udskilles med urinen
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16
Q

Mekanisme:

Aldosteron-receptor-antagonist

A

Hæmmer aldosteron-R i samlerørende

  • hæmningen nedsætter transciptionsfaktore (DNA)
  • hæmmer Na+/K+-ATPasen og Enac (udveksler Na+ og K+ mellem nephronet og blodet)
  • Na+ bliver ikke reduceret i nyren (udskilles)
17
Q

Mekanisme:

Thiazider

A

Distale tubule:

  • hæmmer Na+/Cl- co-transport
  • Na+ udskilles således
18
Q

Mekanisme:

organiske diuretika

A

LM: mannitol

  • kan ikke reabsorberes efter filterering
  • binder til H2O og det udskilles sammen
19
Q

Mekanisme:

CA-hæmmer

A

Carbon-an-hydrase hæmmer (H2CO2)

  • hæmmer omdannelse bicarbonat (HCO3-)
  • og dermed optagelsen af H2O og CO2 (nedbrydsningsprodukter)
20
Q

Mest normale:

diuretika kombinationer

A
  • loop eller thiazid
    + warfarin
    -> loop giver ofte hypokaliæmi, hvor warfarin er K+ besparende