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PHARM 243 (Midterm 2) > Renal 1 > Flashcards

Renal 1 Flashcards

1
Q

Natriuresis

A

Increases Sodium Excretion

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2
Q

Kaliuresis

A

Increased Potassium Excretion

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3
Q

Diuretic

A

Drugs that cause net loss of Na+ and Water in urine

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4
Q

Which Ion is reabsorbed less?

A

Potassium

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5
Q

What drives reabsorption in the Proximal Tubule

A

Na+-K+-ATPase of the basolateral membrane creates low cytoplasmic Na+ concentrations for apical passive transport
(Na+ moves from Lumen to Blood)
(K+ moves from Blood to Lumen)

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6
Q

What drives reabsorption in the Loop of Henle

A

Descending Limb is permeable to water

Thick Ascending Limb is impermeable to water
- Apical Na+/K+/2Cl- cotransporters
–> Na+ Reabsorption

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7
Q

What drives reabsorption in the Distal Tubule

A

Active transport of Na+ by
- Na+/Cl- cotransporter

Calcium excreted by parathyroid hormone

K+ secreted into Distal Tubule

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8
Q

What drives reabsorption in the Collecting Duct

A

Na+ reabsorbed by:
- K+/H+ coupled secretion (Controlled by aldosterone)

Water reabsorption controlled by vasopressin

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9
Q

Aldosterone

A

Primary Endogenous Mineralocorticoid
- Increase Na+ reabsorption
- Increase K+ and H+ excretion

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10
Q

What stimulates Aldosterone release

A

Low plasma Na+ / High K+ influence Zona Glomerulosa
- Stimulates Aldosterone release

Low Na+ increases Angiotensin II
- Stimulates Aldosterone release

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11
Q

Loop Diuretic
- Examples

A

Furosemide, Bumetanide

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12
Q

Loop Diuretic
- Use

A

Most powerful diuretic
Vascular action
- Vasodilation effects are independent of diuresis

Treats serious salt/water overload:
- Acute Pulmonary Edema
- Chronic Heart Failure

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13
Q

Loop Diuretic
- MOA

A

Inhibits Na+/K+/2Cl- of the TAL
- Binds to the Cl- binding site on the luminal membrane (TAL)

Prevents reabsorption, water and ions stay in the lumen

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14
Q

Loop Diuretic
- Adverse Effects

A
  • Excessive Na+ and Water loss
  • Hypovolemia
  • Hypokalemia
  • Hypocalcemia
  • Hyperuricemia (Too much Uric acid - Less Blood volume)
  • Hearing Loss (From ion balance loss)
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15
Q

Thiazides
- Examples

A

Bendroflumethiazide
Hydrochlorothiazide

Related Drugs
- Chlortalidone
- Indapamide
- Metolazone

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16
Q

Thiazides
- Use

A

Less powerful than loop diuretics
Synergistic with loop diuretics

Treats:
- Hypertension

17
Q

Thiazides
- MOA

A

Binds to 2Cl- site of Na+/Cl- co-transporters on the distal tubule
- Increases renin secretion
- Increases natriuresis (Na+ loss)
- Reduces Ca2+ excretion

18
Q

Thiazide
- Adverse Effects

A
  • Erectile Dysfunction (Reversible, less common with low dose)
  • Impaired glucose tolerance (Related to effects on ATPase channels)
  • Hypokalemia (Potassium is being secreted)
  • Hypercalcemia (Calcium builds up)
19
Q

Potassium Sparing Diuretics
- Examples

A

Spironolactone, Eplerenone

20
Q

Potassium Sparing Diuretics
- Use

A

Not used by themselves
Combined with loop diuretics and thiazide to prevent hypokalemia

Treats:
- Heart failure
- Resistant essential hypertension

21
Q

Potassium Sparing Diuretics
- MOA

A

Aldosterone Antagonists
- Competes with aldosterone for its intracellular response

Inhibits distal Na+ retention and K+ secretion in the collecting tubule
- Sodium stays in lumen
- Potassium stays in blood

22
Q

Potassium Sparing Diuretics
- Adverse Effects

A
  • Hyperkalemia

Less with Eplerenone
- Gynecomastia
- Menstrual Disorders
- Testicular Atrophy

23
Q

Other Diuretics
- Examples

A

Triamterene, Amiloride

24
Q

Other Diuretics
- Use

A

Limited use when used by themselves
Combined with loop diuretics and thiazides to prevent hypokalemia

25
Q

Other Diuretics
- MOA

A

Inhibits Na+ reabsorption of the collecting tubule
- Block lumenal Na+ channels that are regulated by aldosterone

26
Q

Other Diuretics
- Adverse Effects

A

Hyperkalemia

27
Q

Osmotic Diuretics
- Example

A

Mannitol

28
Q

Osmotic Diuretics
- MOA

A

Has no pharmacological effect on body
- Is filtered by glomerulus, however, is not reabsorbed
- Increases the osmotic pressure of all parts of the nephron permeable by water
(Proximal Tubule, Loop of Henle, Distal Tubule, Collecting Tubule)

29
Q

Osmotic Diuretics
- Adverse Effects

A

Water is squeezed out of cells
- Can increase risk for precipitating left ventricular failure
- Can increase risk of pulmonary edema

PHARM 243 (Midterm 2) (11 decks)

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