Pharmacology of the Kidney Flashcards
what does aldosterone stimulate
sodium uptake
potassium excretion
where does renin come from and what does it do
from the kidney and stimulates angiotensiogen release from the kidney
where is angiotensin 1 converted to angiotensin 2
by ACE in the lungs
what does AG2 do
stimulate aldosterone and vasoconstriction
what type of drugs block renin release from the kidneys
beta blockers
what stimulates the kidney to release renin
pressure changes in afferent arteriole
sympathetic tone
macula densa chloride or osmotic concentration changes
local prostaglandin and NO release
what is the role of ACEi and where does it cat
inhibits vasoconstriction effect of AG2
acts on efferent arteriole
modulates intraglomerular pressure
increases sodium and water excretion
what are the indications of ACEi
hypertension
cardiac failure
CKD - reduces the intra renal pressure
what are the side effects of ACEi
hypotension - risk of AKI
hyperkalaemia - inhibits action of aldosterone
give two examples of ACEi
ramipril
lisinopril
what is the role of ARBs and what does it act on
inhibits vasoconstriction effect of AG2 on the receptor
acts on efferent arteriole
modulates intraglomerular oressure increases sodium and water excretion
what are the indications fo ARBs
hypertension
cardiac failure
CKD
what are the side effects of ARBs
hypotension
hyperkalaemia - inhibits action of aldosterone
what are two examples of ARBs
valsartan
irbesartan
where do osmotic diuretics work and what is an example
mannitol on the bowman capsule - modifies what is filtered
what is acetazolamide and where would it work
carbonic anhydrase inhibitor which works on both DCT and PCT to cause more Na+ excretion and water excretion
what is spironolactone and what does it do
inhibits aldosterone which stops Na reabsorption in the DCT
where do thiazides work
on the DCT to stops sodium reabsorption
give two examples of loop diuretics
furosemide
bumetanide
what does amiloride do
stops Na absorption in the DCT
what is the action of loop diuretics and when would you use them
inhibits uptake of water sodium potassium and chloride
CKD
nephrotic syndrome
hypertension
cardiac failure
what are the side effects of loop diuretics
hypovolaemia
hypokalaemia
when would you use thiazides
CKD
nephrotic syndrome
hypertension
cardiac failure
what conditions would you use sprionlactone
cardiac failure or liver cirrhosis - ascites
