The Kidney and Drugs Flashcards
Bumetanide is an example of what type of drug?
Loop diuretic
Loop diuretics work by blocking the action of what?
Na+/K+/2Cl- triple co-transporter
Where in the nephron do loop diuretics exert their effect?
Thick ascending loop of Henle
Loop diuretics have what effect on all ion concentrations in the blood?
Decreased
How long does it take for loop diuretics to act when given orally or IV?
1 hour if given orally, 30 minutes if given IV
Loop diuretics are usually used to treat what?
Peripheral or pulmonary oedema
What electrolyte abnormality can loop diuretics be used to treat?
Hypercalcaemia
Which acid-base disorder is caused by the use of loop diuretics?
(Hypokalaemic) metabolic alkalosis
Which group of diuretic drugs are ototoxic? This side effect is enhanced if they are used alongside which other drug?
Loop diuretics cause ototoxicity which is enhanced when used alongside gentamicin
Metolazone is an example of what type of drug?
Thiazide diuretic
Thiazide diuretics work by blocking the action of what?
Na+/Cl- co-transporter
Where in the nephron do thiazide diuretics exert their effect?
Distal convoluted tubule
In someone using a thiazide diuretic, what happens to the level of calcium in the blood?
High (hypercalcaemia)
In someone using a thiazide diuretic, what happens to the level of calcium in the urine?
Low (hypocalciuria)
Thiazide diuretics lead to reduced excretion of uric acid. This leads to what side effect?
Gout
Thiazide diuretics are used in the treatment of what?
Hypertension and long-term oedema
Which type of diuretic can be used to reduce renal stone formation in patients with idiopathic hypercalciuria?
Thiazides
What effect do thiazide diuretics have on blood glucose levels?
Increased (hyperglycaemia)
How do spironolactone and eplerenone work as potassium sparing diuretics?
They are aldosterone antagonists
How do amiloride and triamterene work as potassium sparing diuretics?
They block sodium reabsorption in the collecting duct
Which type of potassium sparing diuretic has a faster onset of action - spironolactone or amiloride?
Amiloride
Why are potassium sparing diuretics usually given in combination with another type of diuretic?
Because alone there is a risk of hyperkalaemia
Which acid-base disorder can be caused by the use of potassium sparing diuretics?
Metabolic acidosis
Which type of diuretic drugs cause anti-androgenic side effects e.g. gynaecomastia?
Aldosterone antagonists (a type of potassium sparing diuretic)
Mannitol is an example of what type of drug?
Osmotic diuretic
Which is the only type of diuretic to be freely filtered at the glomerulus?
Osmotic diuretics
At which points in the nephron do osmotic diuretics exert their effect?
Proximal convoluted tubule and loop of Henle
Osmotic diuretics are usually used for what clinical purpose?
To reduced intra-ocular or intra-cranial pressure
What are some side effects of osmotic diuretics?
Headache, nausea and vomiting
Acetazolamide is an example of what type of drug?
Carbonic anhydrase inhibitor
Carbonic anhydrase inhibitors exert their diuretic effect through increasing the excretion of what?
Bicarbonate (and hence sodium)
Carbonic anhydrase inhibitors act on what portion of the nephron?
Proximal convoluted tubule
Carbonic anhydrase inhibitors are used mainly in the treatment of what condition?
Glaucoma
What effect do vasopressin 2 receptor antagonists have?
Excretion of water without accompanying sodium
Tolvaptan is an example of what type of drug?
Vasopressin V2 receptor antagonist
Name two conditions in which vasopressin 2 receptor antagonists are used as a treatment?
ADPKD and SIADH
Canagliflozin and dapagliflozin are examples of what type of drug?
SGLT2 inhibitors
SGLT2 inhibitors are used in the treatment of what?
Type 2 diabetes
The SGLT2 transporter, inhibited by SGLT2 inhibitors, is located on which part of the nephron?
Proximal convoluted tubule
What effect do SGLT2 inhibitors have on weight?
Weight loss
What is the most common adverse effect of SGLT2 inhibitors?
Genital infections (bacterial and fungal)
A combination of an aminoglycoside with which other group of drugs is particularly nephrotoxic?
Loop diuretics
What type of drugs may cause renal damage by causing crystal nephropathies?
Antivirals
