Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Trial > PCOL of Diuretics > Flashcards

PCOL of Diuretics Flashcards

1
Q

Functions of Kidney (6)

A
  1. Regulate water, inorganic ion, acid-base balance and blood volume
  2. Remove metabolic waste products via urine
  3. Remove foreign chemicals via urine
  4. Gluconeogenesis
  5. Renal metabolism of substances
  6. Acts as secretory gland
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Functional unit of a kidney

A

Nephron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Processes During Urine Formation (3):

A
  1. Glomerular Filtration
  2. Tubular Reabsorption
  3. Tubular Secretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Glomerular Filtration:

  • Glomerular filtrate has same ___-_______ solute concentration as plasma
  • Glomerular filtration rate (GFR) definition: ______ of fluid _____ per unit ____.
    ~~Average adult GFR is ___ L/day
  • GFR subject to __________ regulation
    ~~Constriction of afferent arterials = ________ GFR
    ~~Constriction of efferent arterials = ________ GFR
    ~~Constriction of glomerular mesangial cells = _________ GFR
A
  • non-protein
  • volume, filtered; time
    ~~180
  • physiological
    ~~decrease
    ~~increase
    ~~decrease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the percentage of tubular reabsorption of urea, and is it useful or waste?

A
  • 44%

- waste

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the percentage of tubular reabsorption of water, and is it useful or waste?

A
  • 99%

- useful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the percentage of tubular reabsorption of glucose, and is it useful or waste?

A
  • 100%

- useful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the percentage of tubular reabsorption of Na+, and is it useful or waste?

A
  • 99.5%

- useful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tubular Secretion:

  • Moves substances from _________ _________ into the _____ of the nephron
  • Many _______ _______ and ______ substances are also secreted
  • Requires active transport across __________ (on the blood side) membrane or across ______ (on the luminal side) membrane
  • __ and __ secretion usually coupled with reabsorption of ___
  • Usually under ________ control
A
  • peritubular capillaries, lumen
  • organic anions (choline and creatinine) and foreign (penicillin)
  • basolateral, apical
  • H+ and K+, Na+
  • physiologic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 2 most important secreted substances?

A
  • H+

- K+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Nephron Division of Labor:

What is the primary role of the proximal tubule?

A

to reabsorb most filtered water and nonwaste plasma solutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Nephron Division of Labor:

The Loop of Henle is important in?

A

reabsorbing large quantities of ions (and water, to a lesser extent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Nephron Division of Labor:

Distal segments of the tubule is where ____-______ of final urine occurs

A
  • fine-tuning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Na+ Reabsorption

Na+ and water filter freely from __________ capillaries into _______ _______.

A

glomerular, Bowman’s capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Is Na+ reabsorption an active or passive process?

A

active

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Na+ reabsorption occurs in all tubular segments except

A

descending limb of loop of Henle

17
Q

Why is it important to remember that the amount of Na+ reabsorption varies down the length of the tubule?

A

This is linked to the MOA of our diuretics and it will reflect the efficacy of these diuretics.

18
Q

The Na+/K+ ATPase is always on the _________________ side:

  1. __________ ___________ cells
  2. __________ ___________ ____ cells
A

basolateral

  1. proximal convoluted
  2. cortical collecting duct
19
Q

Water reabsorption is by _________ and is influenced by the movement of ___.

A

diffusion, Na+

20
Q

Water permeability varies along tubule:

  • _______ _________ ______ very water permeable
  • _________ ____ water permeability varies with the presence of ___________
A
  • Proximal Convoluted Tubule (PCT)
  • Collecting duct; vasopressin (antidiuretic hormone; ADH)

ADH - secreted by pituitary

21
Q

Vasopressin -

  • Peptide hormone secreted by _______ ________
  • Stimulates insertion of __________ into luminal membrane of collecting ducts
  • High plasma vasopressin concentrations _______ urine volume
A
  • posterior pituitary
  • aquaporins
  • decrease
    (hyperosmotic urine compared to plasma)
22
Q

Dependence of Water Reabsorption on Na+

Local osmolarity is ___________ in the tubular lumen as Na+ _______

A

decreased, leaves

23
Q

Dependence of Water Reabsorption on Na+

Local osmolarity is ___________ in the interstitial fluid as Na+ _______

A

increased, leaves

24
Q

Diuretics in general work by (4):

A
  • Affecting the specific renal epithelial tubular membrane transporters
  • Exerting osmotic effects that prevent water reabsorption
  • Inhibiting enzymes
  • Interfering with hormone receptors in renal epithelial cells
25
Q

Pharmacology of drug is linked to _______ ____ of renal physiology.

The efficacy of diuretics is __________ to the amount of Na+ reabsorbed at their site of action.

A

specific site

proportional

26
Q

First practical and powerful agent available for widespread use was:

A

chlorothiazide

27
Q

Classification of diuretics has historically been a mosaic of (5):

A
  • site of action
  • efficacy
  • chemical structure
  • similarity of action
  • effects on K+ excretion
28
Q

Sites of Action:

A
  1. PCT
  2. Ascending Loop of Henle
  3. DCT
  4. Collecting Duct
  5. Lumen
29
Q

Diuretics that work in the proximal convoluted tubule:

A

Carbonic Anhydrase Inhibitors

30
Q

CAI - Pharmacodynamics:

  • ____ can be reabsorbed at other sites of nephron independent of carbonic anhydrase
  • ______ decreases in a few days due to _________ enhancement of ____ reabsorption in later parts of tubule
A
  • HCO3-
    (but still have significant HCO3- loss which may cause hyperchloremic metabolic acidosis)
  • Efficacy; compensatory; NaCl
31
Q

CAI - Pharmacokinetics:

  • _______ urine pH within __ minutes of dose
  • Excretion by _______ in ___ (gets drug to site of action)
  • _______ dose for renal insufficiency
A
  • Increased; 30
  • secretion; PCT
  • Adjust
32
Q

CAI - Clinical Uses:

A
  1. Glaucoma – get decreased aqueous humor production
  2. Urinary alkalization
  3. Metabolic alkalosis
  4. Acute mountain sickness
33
Q

CAI - Toxicity

A
  1. Hyperchloremic metabolic acidosis
  2. Renal stones
  3. Renal potassium wasting
  4. Other:
    - Drowsiness
    - NS toxicity (in renal failure patients)
    - Hypersensitivity
34
Q

CAI - Contraindications:

A

May contribute to hyperammonemia and hepatic encephalopathy for cirrhotic patients

35
Q

Diuretics that work in the ascending limb of the loop of henle

A

Loop diuretics

Trial (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions