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Renal > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is oedema?

A

An imbalance between formation and absorption of interstitial fluid.

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2
Q

An increase in what pressure causes oedema?

A

Capillary hydrostatic pressure

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3
Q

A decrease in what can cause the formation of interstitial fluid?

A

Protein

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4
Q

What is nephrotic syndrome?

A

Glomerular filtration issue which allows protein in filtrate and therefore proteinuria.

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5
Q

If interstitial fluid collects, what does this do the blood volume?

A

Decreases it.

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6
Q

If blood volume is low, how is this corrected?

A

RAAS system activated

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7
Q

What does proteinuria look like?

A

Frothy

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8
Q

How does CHF cause oedema?

A

Reduced CO causes renal hypo perfusion which activates RAAS.
Increased capillary pressure leads to oedema.

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9
Q

How does hepatic cirrhosis with ascites cause oedema?

A

Increased pressure in hepatic portal vein and less albumin causes movement of fluid into peritoneum.
RAAS system activated.

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10
Q

Which diuretic works on TAL of loop of Henle?

A

Loop diuretics

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11
Q

Which diuretic works on DCT?

A

Thiazide diuretic

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12
Q

Where does potassium sparing diuretics work on?

A

Collecting tubule

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13
Q

At which membrane do diuretics work on?

A

Apical membrane on tubular cells

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14
Q

Which diuretic are acidic?

A

Thiazides and loop diuretics

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15
Q

Which transport systems work with acidic drugs?

A

Organic anion transporters (OAT)

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16
Q

What kind of substance is the anion swapped for at the basolateral membrane?

A

Ketone.

alpha- ketoglutarate.

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17
Q

What transporter do loop diuretics work on?

A

Triple transporter

Na+/K+/2Cl-

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18
Q

How do loop diuretics work?

A

Blocks triple transporter so sodium is retained in tubular lumen and gets peed out. Water follows sodium

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19
Q

Give an example of a loop diuretic

A

Furosemide

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20
Q

When would loop diuretics be used?

A 
Acute pulmonary oedema
Chronic Heart failure
Ascites
HTN
Chronic kidney failure
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21
Q

What are the adverse effects of loop diuretics?

A

Potassium loss
Metabolic alkalosis
Hypovolaemia
Increased plasma uric acid

22
Q

How do thiazide diuretics work?

A

Block the Na+/Cl- co-transporter in DCT

23
Q

Give an example of a thiazide diuretic

A

Bendroflumethiazide

24
Q

Where are thiazide diuretics used?

A

Mild heart failure
HTN
Resistant oedema
Nephrolithasis

25
Q

Give an example of potassium sparing diuretics

A

Spironolactone.

26
Q

How does spironolactone work?

A

Competes with aldosterone for binding to Na+/KATPase pumps

27
Q

When are potassium sparing diuretics used?

A

In conjunction with agents that cause hypokalaemia or will cause HYPERkalaemia

28
Q

Where do osmotic diuretics work?

A

PCT.

29
Q

How do osmotic diuretics enter the renal system?

A

Glomerular filtration

30
Q

Give an example of an osmotic diuretic

A

Mannitol

31
Q

What effect does aldosterone have on Na+?

A

Na+ reabsorption to blood

32
Q

What effect does aldosterone have on K+?

A

Secretion of K+

33
Q

What effect does vasopressin have on water?

A

Increases water reabsorption

34
Q

What are vaptans?

A

Competitive antagonists of vasopressin receptors

35
Q

What effect do vaptans have on water?

A

Block V2 receptors which causes excretion of water.

36
Q

What effect do vaptans have on sodium?

A

Do not change sodium levels but increase the concentration

37
Q

What vaptans are available for use?

A

Conivaptan

Tolvaptan

38
Q

When are vaptans used?

A

SIADH

39
Q

What do SGLT2 co-transporters do?

A

Allow renal reabsorption of glucose in PCT

40
Q

Where are SGLT1 cotranporters?

A

Intestine

41
Q

How do SGLT2 cotransporters work?

A

Na+:glucose against a concentration gradient

42
Q

What must a clinician remember when doing a urinalysis on a patient on SGLT2 inhibitor?

A

Glucosuria present

43
Q

Name an SGLT2 inhibitor

A

Dapagliflozin

44
Q

Why might SGLT2 inhibitors cause weight loss?

A

Calorific loss of glucose

45
Q

What is a side effect of SGLT2 inhibitors?

A

Increased UTIs

46
Q

Which prostaglandin affects the medulla?

A

PGE2

47
Q

What do prostaglandins do?

A

Vasodilation, prevent sodium loss.

48
Q

When are prostaglandins increased?

A

Trauma
Ischaemia
Bradykinin

49
Q

What part of the kidney do prostaglandins affect?

A

Vasodilation of afferent arteriole

50
Q

What hormone does prostaglandin release?

A

Renin from granular cells of juxtaglomerular apparatus

51
Q

Which drugs inhibit prostaglandins?

A

NSAIDs

52
Q

What effect will NSAIDs have in those with renal dysfunction?

A

Will cause acute renal failure and decrease GFR

Renal (16 decks)

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