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Renal > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Example of an osmotic diuretic

A

Mannitol

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2
Q

Major site of action of osmotic diuretics

A

Proximal tubule

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3
Q

Effect of osmotic diuretics

A

Water retention,

Decreased sodium reabsorption

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4
Q

Uses of osmotic diuretics

A

prevention of acute hypovolaemic renal failure to maintain renal flow
acutely raised IOP and ICP

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5
Q

What else can cause osmotic diuresis?

A

hyperglycaemia

use of iodine based radio-contrast dyes

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6
Q

What is the effect of carbonic anhydrase inhibitors?

A

increased secretion of bicarbonate, and with it some K, Na and water too.
causes ALKALINE URINE

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7
Q

metabolic effect of carbonic anhydrase inhibitors?

A

metabolic acidosis

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8
Q

What does aldosterone activate on the apical membrane?

A

ENAC

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9
Q

Effect of aldosterone?

A

Increased synthesis of Na+K+ ATPase&raquo_space; Sodium reabsorption and therefore water reabsorption

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10
Q

What receptor does ADH act on? Effect?

A

V2. Effect is ^ aquaporins on the apical membrane&raquo_space; increased water diffusion across the apical membrane&raquo_space; water reabsorption

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11
Q

What do SGLT2 inhibitors cause?

A

excretion of glucose, decreased HbA1c, weight loss

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12
Q

Treatment for neurogenic DI?

A

desmopressin - selective for V2

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13
Q

What are Aquatics/Vaptans? what is their effect?

A

Competitive antagonists of vasopressin receptors

Water loss WITHOUT sodium loss

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14
Q

What is tolvaptan used for?

A

SIADH to correct hyponatraemia

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15
Q

What are prostaglandins?

A

Vasodilators

Natriuretic (promote sodium loss)

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16
Q

What causes prostaglandin synthesis?

A 
Ischaemia 
mechanical trauma
ADH
Angiotensin II 
Bradykinin
17
Q

How do prostaglandins effect GFR?

A

directly vasodilate the afferent arteriole
vasoconstrictor the efferent arteriole by causing renin release
this increases filtration pressure

18
Q

What drugs inhibit COX and therefore decrease production of PGE? what may be the result of this if the patient has ever cirrhosis/heart failure/nephrotic syndrome?

A

NSAIDS!

may precipitate acute renal failure

19
Q

What is the ‘triple whammy effect’?

A

NSAID + diuretic + ACEI/ARB

Renal (9 decks)

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