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2nd Year - Renal > Pharmacology 1 - Drugs Acting on the Kidneys 1 (main points) > Flashcards

Pharmacology 1 - Drugs Acting on the Kidneys 1 (main points) Flashcards

1
Q

What is the action of diuretics and how do they do this?

A

Increase urine output through causing a net electrolyte (mainly sodium) and water loss

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2
Q

Give 3 examples of conditions that diuretics are used in?

A

Hypertension
CHF
Hepatic cirrhosis with ascites

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3
Q

What are the 2 ways in which diuretics can get into the filtrate?

A

Glomerular filtration

Secretion via transport process in the proximal tubule

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4
Q

Which type of drugs do organic anion transporters in the proximal tubule secrete?

A

Acidic drugs

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5
Q

What type of drugs do organic cation transporters in the proximal tubule secrete?

A

Basic drugs

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6
Q

Are thiazides and loop diuretics acidic or basic?

A

Acidic

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7
Q

Name the diuretic which is a carbonic anhydrase inhibitor?

A

Acetazolamide

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8
Q

What does acetazolamide inhibit?

A

Reabsorption of HCO3- in the proximal convoluted tubule

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9
Q

Does acetazolamide have strong or weak diuretic properties?

A

Weak

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10
Q

Name 3 loop diuretics

A

Furosemide
Torsemide Bumetanide
Ethacrynic acid

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11
Q

What part of the loop of henle do loop diuretics act on?

A

Ascending limb

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12
Q

What do loop diuretics inhibit?

what effect does this have?

A

Na+/K+/2Cl- cotransporter

Retention of Na+, Cl- and water in the tubule

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13
Q

Which type of diuretic are the most efficacious?

A

Loop diuretics

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14
Q

What part of the tubule do thiazide diuretics work on?

A

Distal convoluted tubule

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15
Q

What effect do thiazide diuretics have?

A

Inhibit the reabsorption of Na+ and Cl- in the distal convoluted tubule resulting in the retention of water in the tubule

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16
Q

Name 3 diuretics that act on the collecting duct?

A

Spironolactone
Amiloride
Triamterene

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17
Q

What type of drug is spironolactone?

A

Aldosterone antagonist (diuretic)

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18
Q

What effect does spironolactone have?

A

Inhibits the aldosterone-mediated reabsorption of Na+ and secretion of K+

19
Q

How do amiloride and triamterene have their effects?

A

Block Na+ channels in the collecting duct

20
Q

Aside from Na+ and K+ loss, what other ions are increasingly excreted due to loop diuretics?

A

Ca2+ and Mg2+

21
Q

What property of loop diuretics makes them especially beneficial in pulmonary oedema caused by heart failure?

A

Possess an additional, indirect, venodilator action

22
Q

Loop diuretics are poorly absorbed from he GI tract - true or false?

A

False - well absrobed

23
Q

Are loop diuretics effective in severe renal failure?

A

Yes, they may reduce need for dialysis

24
Q

Why are loop diuretics sometimes used in hypercalcaemia and renal stones?

A

To increase Ca2+ excretion

25
Q

Name 8 side effects of loop diuretics?

A 
Hypokalaemia
Metabolic alkalosis 
Hypovolaemia
Hypotension
Depletion of calcium and magnesium
Hyperglycaemia
Hyperuricaemia
Hearing loss
26
Q

How can hypokalaemia from loop diuretic use be corrected?

A

Concomitant use of potassium sparing diuretics or potassium supplements

27
Q

Are thiazide diuretics more or less potent than loop diuretics?

A

Less potent

28
Q

Effect of thiazide diuretics on Ca2+ and Mg2+?

A

Save these

29
Q

What do thiazide diuretics bind to?

A

Na+Cl- symporter in distal convoluted tubule

30
Q

Why are thiazide diuretics especially useful in the treatment of hypertension?

A

Possess an additional indirect vasodilator action

31
Q

What type of diuretics can be used in the treatment of nephrogenic diabetes insidious?

A

Thiazide

32
Q

Are thiazide or loop diuretics absorbed more quickly after oral administration?

A

Loop (30-40 mins) vs thiazides (1 to 2 hours)

33
Q

At what time of day are thiazide diuretics normally administered?

A

Early (to prevent diuresis interfering with sleep)

34
Q

Do thiazide diuretics work in renal failure?

A

No - ineffective if eGFR less than 30

35
Q

Name of thiazide diuretic used in mild/ moderate heart failure?

A

Bendroflumethiazide

36
Q

Name of thiazide diuretic often used with a loop?

A

metolazone

37
Q

Name of a long acting thiazide diuretic?

A

Xipamide

38
Q

What type of acid base problem do thiazide diuretics cause?

A

Metabolic alkalosis

39
Q

Effect of thiazide diuretics on K+, Na+, Mg2+ and Ca2+?

A

Hypokalaemia
Hyponatraemia
Hypomagensaemia
Hypercalcaemia

40
Q

Effect of thiazide diuretics on glucose and lipid levels

A

Hyperglycaemia

Hyperlipidaemia

41
Q

Can thiazide diuretics lead to gout?

A

Yes

42
Q

Effect of thiazide diuretics on blood counts?

A

Can cause low blood counts

43
Q

What rarer side effect can thiazide diuretics have in men?

A

Impotence

44
Q

Would an equipotent of thiazide or loop diuretic tend to cause a greater degree of hypokalaemia?

A

Thiazide (Loop diuretics have a shorter duration of action = intermittent compensation)

2nd Year - Renal (6 decks)

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