Trachte Flashcards

1
Q

loop diuretics

A

furosemide

bumetanide

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2
Q

loop diuretics mech

A
  • block Na/K/2Cl transport in ascending limb of loop of Henle
  • accounts for 25% Na reabsorption
  • dramatically increases Na, K, and H20 EXCRETION
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3
Q

thiazide diuretic

A

chlorthalidone
hydrochlorathiazide
metalozone

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4
Q

thiazide diuretic mech

A
  • block Na/Cl transport in distal convoluted tubule
  • accounts for 8% Na reabsorption
  • MILDER increase in Na and K EXCRETION (than loop diuretics)
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5
Q

potassium sparing diuretics

A

spironolatcone
eplerenone
amiloride
triamterene

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6
Q

potassium sparing diuretics mech

A
  • block ALDO receptors (spironolactone and eplerenone)
  • block the Na exchange for K and H (amiloride and triamterene)
  • MILD diuretics, primarily prevent excessive K wasting = block exchange of Na/K in collecting tubule
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7
Q

ADH and desmopressin

A
  • increase aquaporin channels in collecting duct

- allows CONCENTRATION OF URINE

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8
Q

osmotic diuretics

A

mannitol

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9
Q

osmotic diuretic mech

A

exert osmotic effect in proximal tubule to REDUCE H2O REABSORPTION

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10
Q

SGLT-2 inhibitors

A

canigliflozin

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11
Q

SGLT-2 inhibitors mech

A
  • reduces glucose reabsorption
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12
Q

carbonic anhydrase inhibitors

A

acetazolamide

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13
Q

carbonic anhydrase inhibitor mech

A
  • block the reabsorptive processes in proximal tubule

- major utility in glaucoma or excess CSF production or urinary alkalinization

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14
Q

probenicid

sulfinpyrazone

A
  • suppress uric acid reabsorption in gout
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15
Q

microtubule inhibitor in gout

A

colchicine

- suppress uric acid reabsorption in gout

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16
Q

xanthine oxidase inhibitor

A

allopurinol

- suppress uric acid reabsorption in gout

17
Q

therapeutic uses loop diuretics

A
  1. pulmonary edema
  2. other edematous condition
  3. hyperkalemia
  4. acute renal failure
  5. anion overdose (bromide, fluoride, iodide)
18
Q

loop diuretic effect on urine

A
  • increase NaCl excretion

- increase K excretion

19
Q

why is some K excreted when trying to rid NaCl?

A

increased Na in lumen exchanged for K in cortical collecting tubule

20
Q

therapeutic uses of thiazides

A
  1. HTN
  2. HF
  3. nephrolithiasis caused by hypercalcemia
  4. nephrogenic diabetes insipidus
21
Q

major SE thiazides

A
  • HYPERGLYCEMIA (thiazides bind to SUR on K channel controlling insulin release –> opens channel –> K enters –> hyperpolarizes beta cell –> suppress insulin release)
  • hyperuricemia
  • hypokalemia
  • hyperlipidemia
  • hyponatremia
  • allergic rxn
22
Q

aldosterone receptor inhibitors

A

spironolactone

eplerenone

23
Q

Na/K/H exchange in cortical collecting duct inhibitors

A

amiloride

triamterene

24
Q

therapeutic uses K sparing diuretics

A
  • hyperaldosteronism***

- prevent K wasting caused by other diuretics

25
Q

SE of K sparing diuretics

A
  • hyperkalemia
  • hyperchloremia metabolic acidosis
  • gynecomastia (spironolactone)
  • acute renal failure
  • kidney stones
26
Q

vasopressin (ADH)/desomopressin used to treat

A
  • diabetes insipidus

- bed wetting

27
Q

vasopressin (ADH)/desmopressin mech

A

stimulation G-protein coupled receptors in collecting duct –> recruit aquaporin channels
= water moves by osmosis through aquaporin to the hyperosmolar medullary region of kidney*

28
Q

osmotic diuretics

A

mannitol

29
Q

osmotic diuretic mech

A

mannitol isn’t reabsorbd in nephron –> osmotic effect –> lumen to retain water

30
Q

osmotic diuretic uses

A

reduce body water or reduce intracranial or intraocular pressure

31
Q

mannitol SE/toxicities

A
  • extracellular volume expansion
  • dehydration, hyperkalemia, hypernatremia
  • hyponatremia when renal function impaired
32
Q

SGLT-2 inhibitors effects

A
  • loss of glucose in urine
  • reduce blood sugar levels in DM
  • weight loss (due to loss of energy/glucose)
  • SE: ketoacidosis, URIs, yeast infection, hypoglycemia
33
Q

treatment of gout

A
  • reduce inflammation with NSAIDS (don’t use ASAs)
  • reduce uric acid (allopurinol, probenicid, sulfinpyrazone inhibits WOA –> promotes excretion)
  • allopurinol
  • colchicine