Renal Flashcards
where do osmotic diuretics have their effect
anywhere that is freely permeable to water:
proximal tubule
descending limb of loop of Henle
collecting duct
where do carbonic anhydrase inhibitors have their effect
proximal tubule
where do loop diuretics have their effect
ascending limb of loop of Henle
where do thiazides have their effect
ascending limb of loop of Henle
where do potassium sparing diuretics have their effect
collecting duct
what are the 2 classes of K+ sparing drugs
aldosterone receptor antagonists
inhibitors of aldosterone-sensitive Na+ channels
how do carbonic anhydrase inhibitors work
stop the carbonic anhydrase enzyme so that bicarbonate cannot exit the lumen and instead stays there with sodium. water therefore also stays in the lumen
how do loop diuretics work
block the Cl binding site on the Cl/Na/K transport protein in the ascending limb
this prevents movement of Na out of the lumen
this also decreases the osmolality in the medullary interstitium
what is the most powerful diuretic
loop diuretic - 15-30% fluid loss
how do thiazides work
inhibit Na and Cl reabsorption in the early ascending limb of the loop of Henle
how powerful are thiazides
not as powerful as loop diuretics, only about 5-10% fluid loss
how do potassium sparing diuretics work
inhibit Na reabsorption in the early distal tubule
