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Y2 Renal > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

what is the site of action of most diuretics?

A

the apical membrane of tubular cells

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2
Q

what must diuretics do in order to work?

A

enter the tubular filtrate

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3
Q

by what two mechanisms can diuretics enter the filtrate?

A

glomerular filtration

secretion into the proximal tubule via OATs and OCTS

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4
Q

what is an OAT?

A

organic anion transporter

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5
Q

what do OATs transport?

A

acidic drugs

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6
Q

what is an OCT?

A

organic cation transporter

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7
Q

what do OCTs transport?

A

basic drugs

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8
Q

name two loop diuretics

A

furosemide

bumetanide

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9
Q

what do loop diuretics work on?

A

block the triple co transporter

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10
Q

what are the main effects of loop diuretics?

A

increase sodium in filtrate
increase potassium loss
increase excretion of calcium and magnesium

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11
Q

how do loop diuretics enter the nephron?

A

via OATs

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12
Q

what are the four clinical indications of loop diuretics?

A

reduce salt and water overload
increase urine in AKI
hypertension
acute hypercalcaemia

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13
Q

what are the two contraindications for loop diuretics?

A

severe hypovolemia

dehydration

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14
Q

what are the three cautions for loop diuretics?

A

hyponatraemia
hepatic encephalopathy
gout

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15
Q

what low electrolyte states can loop diuretics cause?

A

hypokalaemia
metabolic alkalosis
hypocalcaemia
hypomagnesaemia

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16
Q

what are some side effects of loop diuretics?

A

hypovolaemia and hypotension
hyperuricemia
loss of hearing

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17
Q

name a thiazide diuretic

A

bendroflumethiazide

18
Q

name two thiazide like diuretics

A

indapamide

metolazone

19
Q

what do thiazide diuretics work on?

A

the sodium chloride carrier

20
Q

what are the main effects of thiazide diuretics?

A

increase sodium delivered to collecting duct
cause potassium loss
increase reabsorption of calcium

21
Q

how do thiazide diuretics enter the nephrons?

A

OATs

22
Q

what are the main clinical indications for thiazide diuretics?

A

heart failure

hypertension

23
Q

what are some less common uses for thiazide diuretics?

A

resistant oedema
renal calculi
nephrogenic DI

24
Q

what is the contraindication to thiazide diuretics?

A

hypokalaemia

25
Q

what are the cautions for thiazide diuretics?

A

hyponatraemia

gout

26
Q

name an osmotic diuretic

A

mannitol

27
Q

how are osmotic diuretics administered and why?

A

IV

membrane impermeable so wouldn’t be absorbed by the GI tract

28
Q

how do osmotic diuretics enter the nephron?

A

by glomerular filtration

cannot be reabsorbed in the nephron

29
Q

what do osmotic diuretics do when in the nephron?

A

increase osmolality of filtrate by opposing water reabsorption

decreases sodium reabsorption

30
Q

name two times that osmotic diuretics would be used

A

preventing acute hypovolemic renal failure

acute raised ICP

31
Q

what are two possible adverse effects of osmotic diuretics?

A

transient expansion of blood volume

hyponatraemia

32
Q

name a carbonic anhydrase inhibitor

A

acetazolamide

33
Q

how does a carbonic anhydrase inhibitor work?

A

increases excretion of bicarbonate (and sodium, potassium and water)

= alkaline urine

34
Q

what are carbonic anhydrase inhibitors used for?

A

glaucoma
post eye surgery
altitude sickness

35
Q

what is the main role of aquaretics?

A

act as competitive antagonists of vasopressin receptors

36
Q

what are the three subtypes of vasopressin receptors?

A

V1A
V1B
V2

37
Q

what do V1A receptors mediate?

A

vasoconstriction

38
Q

what do V2 receptors mediate?

A

water reabsorption in collecting tubules

39
Q

what effect does blocking V2 receptors have?

A

excretion of water without sodium = raises sodium concentration

40
Q

name two aquaretics

A

conivaptan

tolvaptan

41
Q

when is tolvaptan used?

A

in SIADH to manage hyponatremia

Y2 Renal (29 decks)

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