Renal Pharm - Diuretics

Question 1

Found in saliva

Answer 1

Cations and IgG

(along with proteins, urea, ammonia, enzymes, etc).

Question 2

How do diuretics alter saliva?

Answer 2

1) They decrease the salivary flow rate (cause xerostomia).
2) Alter pH and buffering capacity.
3) Alter Na and Cl concentrations.

Question 3

What do Thiazide diuretics inhibit?

Answer 3

Na-Cl symporter

Question 4

What do loop diuretics inhibit?

Answer 4

Na-K-2Cl symporter

Question 5

An increase in the formation of urine.

Answer 5

Diuresis

Question 6

Effect of potassium-sparing diuretics.

Answer 6

Decrease the secretion of potassium, so they’re not good for sinus rhythm of the heart.

Question 7

Why do people take diuretics?

Answer 7

To increase the excretion of water, thus lowering BP.

Question 8

Side effect of diuretics

Answer 8

Orthostatic hypotension due to decreased blood volume.

Question 9

These cells are found in the ascending limb and sense how much Sodium is in the blood.
If there’s too much Na, Na is excreted from the body.

Answer 9

Macula Densa

Question 10

A loop diuretic that inhibits Na-K-2Cl symporter.

Answer 10

Furosemide (Lasix)

Question 11

As you go through the loop of Henle and the nephron, less _______ is being reabsorbed into the blood.

Answer 11

Sodium

Question 12

A potassium-sparing diuretic.

Answer 12

Spironolactone

Question 13

An aldosterone antagonist.

Answer 13

Spironolactone

Question 14

Most of the Na gets actively reabsorbed where in the nephron?

Answer 14

Proximal Tubule

Question 15

What does the Loop of Henle actively transport?

Answer 15

Cotransports Na, K, and 2 Cl.

Question 16

How does Aldosterone work?

Answer 16

Acts on the distal tubule to increase Na reabsorption, which increases BP.

Question 17

K+ is excreted in this part of the nephron.

Answer 17

Distal tubule

Question 18

Where is potassium reabsorbed and excreted?

Answer 18

Reabsorbed in the proximal tubule.

Excreted in the distal tubule.

Question 19

What does potassium secretion in the distal tubule depend on?

Answer 19

(1) The volume of filtrate
(2) The amount of Na that’s reabsorbed
(3) Aldosterone

Question 20

The distal tubule has what mechanism for K excretion?

Answer 20

Na/K antiporter

Question 21

How do diuretics work?

Answer 21

Inhibit Na+ reabsorption, so both Na+ and water are excreted into the urine.

Question 22

Site of action of diuretics.

Answer 22

Luminal surface of the kidney! IMPORTANT

Question 23

Site of action of thiazides.

Answer 23

Distal convoluted tubule

Question 24

Which limb of the Loop of Henle does Furosemide (Lasix) act?

Answer 24

ASCENDING limb

Question 25

What are Thiazide direutics used to treat?

Answer 25

Swelling in the peripheral appendages.

Question 26

A risk factor of taking Spironolactone.

Answer 26

Hyperkalemia where there's too much K+ in the blood because it's a K+ channel blocker and Aldosterone inhibitor. This can also cause arrhythmias bc there's too much K+ in going to the heart. Can go into cardiac arrest.

Question 27

Major diuretic effects of Thiazides

Answer 27

1) Increased Na, Cl, and K excretion. 2) HYPOKALEMIA 3) Inhibits Na reabsorption

Question 28

Minor diuretic effects of Thiazides

Answer 28

1) Increased bicarbonate excretion, so urinary pH INCREASES. 2) Decreased Calcium excretion, so can be used to treat hypercalciURIA. 3) Inhibits uric acid excretion 4) Hyperglycemia

Question 29

Describe the dose-response curve of Thiazides.

Answer 29

Becomes flat, so they lose the amt of effectiveness after a certain dose is reached.

Question 30

Side effect of loop diuretics

Answer 30

Hearing impairment (red text)

Question 31

Action of Furosemide

Answer 31

Inhibits the reabsorption of Na, Cl, K, Mg, and Ca.

Question 32

Dose response curve of loop diuretics.

Answer 32

STEEP!

Question 33

Therapeutic uses of loop diuretics.

Answer 33

``` Pulmonary edema and CHF Edema Hypertension Hyperkalemia Acute renal failure ```

Question 34

What does Spironolactone inhibit?

Answer 34

Aldosterone

Question 35

What kind of diuretic is Spironolactone?

Answer 35

K-sparing

Question 36

Role of cardiac glycosides

Answer 36

Eliminate K

Question 37

Role of NSAID's in BP

Answer 37

Increase BP

Question 38

Effect of diuretics on Lithium

Answer 38

Na gets excreted while Li gets reabsorbed. Can be toxic.

Question 39

A potassium sparing diuretic.

Answer 39

Spironolactone So it inhibits the reabsorption of Na, but prevents the excretion of K.

Question 40

The function of this diuretic depends on the presence of Aldosterone

Answer 40

Spironolactone

Question 41

Two types of Potassium-sparing diuretics.

Answer 41

1) Spironolactone | 2) Triamterene

Question 42

Side Effects of Potassium-Sparing Diuretics

Answer 42

HYPERkalemia

Question 43

Why should you be cautious when taking Lithium and diuretics together?

Answer 43

Since Na is excreted when taking a diuretic, the body reabsorbs more Lithium, leading to toxicity.