Renal Flashcards
Target of mannitol in the kidney
Proximal convolutes tubule and descending loop of Henle
Sugar, amino acid, Na permeable
Water permeable
Target of acetazolamide in the kidney
Proximal convoluted tubule,
Sugar, amino acid, Na permeable
Target of loop diuretics in the kidney
Ascending loop of Henle, salt permeable
Target of thiazide diuretics in the kidney
Distal convoluted tubules, Na, Cl and Ca permeable
Target of K sparing diuretics in the kidney
Near collecting duct, K, H, and Na permeable
Which diuretic is contraindicated in HF?
Mannitol
Causes hypo or hyperNa and can exacerbate pulmonary edema
MOA mannitol, therefore 2 uses
Osmotic diuretic
Decreases intracranial or intraocular pressure
Used for drug overdose
MOA acetazolamide , therefore important side effects
Inhibits carbonic anhydrase —> NaHCO3 diuresis
- ACIDOSIS
- NH3 toxicity
- Ca Ph stone formation
Main uses of acetazolamide (4)
- Glaucoma
- Metabolic alkalosis
- Altitude sickness
- Intracranial hypertension idiopathic
Loop diuretic name termination
-semide
Except bumetanide and ethacrynic acid
MOA loop diuretics
Inhibit Na/K/2Cl cotransport
Excreting Ca
Which diuretics are used for edematous states (HF, cirrhosis, nephrotic syndrome, etc)?
Loop diuretics
Loop diuretic uses (3)
- Edema
- Hypertension
- HyperCa
Loop diuretic main side effects “OHH DAANG!”
Ototoxicity
HypoK
HypoMg
Dehydration
Allergy (sulfa)
Alkalosis
Nephritis
Gout
What is the name of the nonsulfonamide loop diuretic?
Ethacrynic acid
Note: more OTOTOXIC
MOA thiazide diuretics
Inhibit NaCl reabsorption —> less Ca excretion
Thiazide diuretic uses (5) Hint: highly related to its MOA
- Hypertension
- HF
- Idiopathic hyperCa
- Nephrogenic diabetes insipidus
- Osteoporosis
Thiazide diuretic side effects. Hint: hyperGLUC + 3 others
Hyper:
- Glycemia
- Lipidemia
- Uricemia
- Calcemia
Alkalosis hypo K
Hypo Na
Sulfa allergy
Which are K sparing diuretics? Hint: Keep your SEAT
Spironolactone
Eplerenone
Amiloride
Triamterene
MOA K sparing diuretics
-one
= competitive aldosterONE receptor antagonists in collecting tube
Triamterene and amiloride: block Na channels
K sparing diuretics GENERAL uses (3)
- Hyperaldosteronism
- K depletion
- HF
Which K sparing diuretic is used for hepatic ascites?
Spironolactone
Which K sparing diuretic is used for nephrogenic DI?
Amiloride
Which K sparing diuretic is used as an anti-androgenic?
Spironolactone
Main side effect of K sparing diuretics
HYPERK —> arrhythmias
Which K sparing diuretic has more side effects and what are they?
Spironolactone
Gynecomastia, less testosterone, decreased libido, etc.
MOA vasopressin
Antidiuretic hormone
Regulates aquaporin channel in principal cells of collecting duct
What is desmopressin?
ADH analog
Desmopressin uses (2)
Central diabetes insipidus
Nocturnal enuresis
