Renal Drugs Flashcards
The cortex of the kidney is (inside/outside) and the medulla of the kidney is (inside/outside).
- outside
- inside
The Cortex has ______ salt concentration.
The Medulla has ______ salt concentration.
- normal (isosmotic)
- high (hyperosmotic)
What type of filter does the glomerulus have?
A size exclusion filter
The glomerulus filters (Select all that apply):
- Water
- Sodium
- Proteins
- Chloride
- Potassium
- Urea
- Protein-bound Drugs
Water Sodium Chloride Potassium Urea
What is reabsorbed in the Proximal tubules?
Water, Na+, Cl-, K+, Bicarbonate, Urea
The loop of Henle is made up of the ___ _____ limb and ____ _____ limb. What is reabsorbed in each portion?
- thin descending: reabsorbs water
- thick ascending: reabsorbs NaCl
What is reabsorbed in the Distal Convoluted tubule?
NaCl
What is reabsorbed in the Late Distal tubule?
Na+
What causes K+ to be transported into the nephron lumen?
Electrochemical gradient made by N+ reabsorption
Fluid entering the collecting duct is ________ compared to the blood.
hypo-osmotic
Where does vasopressin act on the nephron?
Medullar collecting ducts
What is another name for vasopressin?
Anti-Diuretic Hormone (ADH
What causes the release of vasopressin in the body?
Vasopressin is released in response to low pressure or high salt concentration in circulating fluids. Vasopressin trys to prevent dehydration.
Acetazolamide
1) Mechanism of Action
2) Effects on Excretion
3) Indications
1) Carbonic Anhydrase Inhibitor-inhibits carbonic anhydrase in the lumen and cells of the PROXIMAL TUBULE
2) Increased Na+, Bicarb, K+ excretion, Decreased H+ excretion (can cause metabolic acidosis)
3) Counteract other drugs that cause metabolic alkalosis
* Low efficacy as single diuretic agent
Glycerin (oral)
1) Mechanism of Action
2) Effects on Excretion
3) Indications
1) Osmotic Diuretic-in tissues draws water into the blood, in kidney increases GFR and washing out the medullary salt gradient
2) Excretion of Everything INCREASES
3) Acute Renal Failure, Acute Tubular Necrosis
Mannitol
1) Mechanism of Action
2) Effects on Excretion
3) Indications
1) Osmotic Diuretic-in tissues draws water into the blood, in kidney increases GFR and washing out the medullary salt gradient
2) Excretion of Everything INCREASES
3) Acute Renal Failure, Acute Tubular Necrosis
Furosemide
1) Mechanism of Action
2) Effects on Excretion
3) Indications
1) Loop Diuretics-inhibitor of Na+/K+/2Cl- Symporter in the THICK ASCENDING LIMB of the Loop of Henle
2) Excretion of Everything INCREASES, Especially Na+
3) Acute Pulmonary edema, CHF, Nephrotic syndrome (inorder to slow down GFR), HTN (Thiazides preferred)
* Acutely increases systemic venous capacitance
Bumetanide
1) Mechanism of Action
2) Effects on Excretion
3) Indications
1) Loop Diuretics-inhibitor of Na+/K+/2Cl- Symporter in the THICK ASCENDING LIMB of the Loop of Henle
2) Excretion of Everything INCREASES, Especially Na+
3) Acute Pulmonary edema, CHF, Nephrotic syndrome (inorder to slow down GFR), HTN (Thiazides preferred)
Ethacrynic Acid
1) Mechanism of Action
2) Effects on Excretion
3) Indications
1) Loop Diuretics-inhibitor of Na+/K+/2Cl- Symporter in the THICK ASCENDING LIMB of the Loop of Henle
2) Excretion of Everything INCREASES, Especially Na+
3) Acute Pulmonary edema, CHF, Nephrotic syndrome (inorder to slow down GFR), HTN (Thiazides preferred)
Torsemide
1) Mechanism of Action
2) Effects on Excretion
3) Indications
1) Loop Diuretics-inhibitor of Na+/K+/2Cl- Symporter in the THICK ASCENDING LIMB of the Loop of Henle
2) Excretion of Everything INCREASES, Especially Na+
3) Acute Pulmonary edema, CHF, Nephrotic syndrome (inorder to slow down GFR), HTN (Thiazides preferred)
Hydrochlorothiazide
1) Mechanism of Action
2) Effects on Excretion
3) Indications
1) Thiazide Diuretic-inhibitor of the Na+/Cl- symporter in the DISTAL CONVOLUTED TUBULE
2) DECREASED Ca2+ excretion, Increased K+, Na+, H+
3) HTN, d/t Ca2+ reabsorption can treat Ca2+ Nephrolithiasis (Ca2+ stones) and aid in Osteoporosis treatment
Chlorothiazide
1) Mechanism of Action
2) Effects on Excretion
3) Indications
1) Thiazide Diuretic-inhibitor of the Na+/Cl- symporter in the DISTAL CONVOLUTED TUBULE
2) DECREASED Ca2+ excretion, Increased K+, Na+, H+
3) HTN, d/t Ca2+ reabsorption can treat Ca2+ Nephrolithiasis (Ca2+ stones) and aid in Osteoporosis treatment
Metolazone
1) Mechanism of Action
2) Effects on Excretion
3) Indications
1) Thiazide Diuretic-inhibitor of the Na+/Cl- symporter in the DISTAL CONVOLUTED TUBULE
2) DECREASED Ca2+ excretion, Increased K+, Na+, H+
3) HTN, d/t Ca2+ reabsorption can treat Ca2+ Nephrolithiasis (Ca2+ stones) and aid in Osteoporosis treatment
Amiloride
1) Mechanism of Action
2) Effects on Excretion
3) Indications
1) Renal Na+ Channel Inhibitor-inhibits the Na+ channels in the late distal tubule and collecting duct which in turn inhibits K+secretion
2) Decreased excretion of K+, H+, Ca2+, Mg2+, Increased excretion of Na+, Cl-
3) Co-administration with Thiazides and Loop diuretics to reduce K+ loss
Triamterene
1) Mechanism of Action
2) Effects on Excretion
3) Indications
1) Renal Na+ Channel Inhibitor-inhibits the Na+ channels in the late distal tubule and collecting duct which in turn inhibits K+secretion
2) Decreased excretion of K+, H+, Ca2+, Mg2+, Increased excretion of Na+, Cl-
3) Co-administration with Thiazides and Loop diuretics to reduce K+ loss
Spironolactone
1) Mechanism of Action
2) Effects on Excretion
3) Indications
1) Mineralocorticoid Antagonist-prevents aldosterone from binding to intracellular mineralocorticoid receptor and prevents the change in expression of aldosterone induced proteins which inhibits Na+ resorption in the late distal tubule and collecting duct
2) Decreased K+ excretion, Increased Na+ excretion
3) Hyperaldosteronism, Co-administration with Thiazides and Loop diuretics to reduce K+ loss
Eplerenone
1) Mechanism of Action
2) Effects on Excretion
3) Indications
1) Mineralocorticoid Antagonist-prevents aldosterone from binding to intracellular mineralocorticoid receptor and prevents the change in expression of aldosterone induced proteins which inhibits Na+ resorption in the late distal tubule and collecting duct
2) Decreased K+ excretion, Increased Na+ excretion
3) Hyperaldosteronism, Co-administration with Thiazides and Loop diuretics to reduce K+ loss
Desmopressin
1) Mechanism of Action
2) Indications
1) Antidiuretic-binds V2 receptor to stimulate reabsorption in distal tubule and collecting ducts by stimulating the production of aquaporins in the epithelium
2) Central Diabetes Insipidus
Vasopressin
1)Mechanism of Action
1)Antidiuretic hormone- binds V1 and V2 receptor to stimulate reabsorption in distal tubule and collecting ducts by stimulating the production of aquaporins in the epithelium
Allopurinol
1) Mechanism of Action
2) Indication
1) Uricosuric agent-inhibits xanthine oxidase (enzyme that converts xanthine to uric acid)
2) Gout
Colchincine
1) Mechanism of Action
2) Indication
1) Uricosuric agent-reduces neutrophil activity (unknown actual mechanism of action)
2) Gout
Probenecid
1) Mechanism of Action
2) Indication
1) Initially, decreases excretion of uric acid by blocking organic acid transporter (OAT), once drug is in nephron lumen urate reabsorption pump inhibited resulting in increased excretion of uric acid
2) Gout
