SG Water Handling Flashcards
Where does ADH act upon?
the collecting tubule
Name the drug:
a butyrophenone derivative that is an inverse agonist of dopamine used to treat schizo, psychosis, mania, chorea, Tourette etc Extrapyramidal side effects
Haloperidol (Haldol)
What is the tx for hypovolemia, hypervolemia, and euvolemia, respectively?
- isotonic saline in hypo
- diuretics in hyper
- restricted water intake and ADH blockers in eu
What is the definition of orthostatic hypotension?
the BP drops by 10+ points from sitting to standing, and the HR increased by 10+ points from sitting to standing
What will the total body water be in a hypertonic state?
it can go either direction
What will the serum Na be in hypovolemia, hypervolemia, and euvolemia, respectively?
- VERY increased in hypo
- normal in hyper and eu
Name the 3 subcategories in a hypotonic state.
- hypovolemia
- hypervolemia
- euvolemia
What is the definition of central DI?
no ADH is produced
What is the equation to calculate serum osmolality?
Serum osmolality = (2xNa) + BUN/2.8 + glu/18
Tell me about chlorpropamide.
- a sulfonurea that increases the action of insulin
- used to treat DMII
- not used anymore bc of side effects
What will the urine Na be in hypovolemia, hypervolemia, and euvolemia, respectively?
- decreased in hypo
- depends on the cause in hyper
- increased in eu
For every increase of 100mEq of glucose, there will be an increase of _____ of ______ above normal.
1.6mEq of serum Na
What is the normal urine osmolality value?
300-400
When do you use the corrected Na formula?
if the serum glucose is abnormal
What will the serum Na be in a hypertonic state?
increased
For every increase of _____ of ______, there will be an increase of 1.6mEq of serum Na above normal.
100mEq of glucose
What is the normal value for serum Na? If the corrected Na doesn’t equal this value, what does that tell you?
- 140
- something else has to be wrong other than the abnormal glucose
What will the treatment be for a hypertonic state?
treat the underlying problem
What syndrome can occur if hyponatremia is corrected too quickly in a chronic setting?
central pontine demyelination
What is nephrogenic DI?
the kidney fails to respond to ADH
What happens when ADH is in excess?
water is retained in spite of the body not needing it and serum sodium decreases
What will the total body water be in hypovolemia, hypervolemia, and euvolemia, respectively?
- decreased in hypo
- VERY VERY increased in hyper
- a little increased in eu
Name the drug:
a phenothiazine serotonin antagonist used to treat schizo and psychosis not used anymore bc it causes heart arrhythmias
Thioridazine (Mellaril or Melleril)
Tell me about Haloperidol (Haldol).
- a butyrophenone derivative that is an inverse agonist of dopamine
- used to treat schizo, psychosis, mania, chorea, Tourette etc
- Extrapyramidal side effects
Tell me about Thioridazine (Mellaril or Melleril).
- a phenothiazine serotonin antagonist
- used to treat schizo and psychosis
- not used anymore bc it causes heart arrhythmias
What are some causes of hypertonic states?
excess osmolarity, usually from HYPERGLYCEMIA but also can be uremia or EtOH
What happens to the urine when ADH is blocked?
low urine osmolarity (maximally diluted)
Name the drug.
a sulfonurea that increases the action of insulin used to treat DMII not used anymore bc of side effects
chlorpropamide
A normally functioning kidney maximally filters ___L per day.
24
In an isotonic state, what does a normal osmolarity tell you?
that a lab problem has occured
What will the urine Na be in a hypertonic state?
increased
