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VSCI200 NSF > Urinary pharm > Flashcards

Urinary pharm Flashcards

1
Q

Osmotic diuretics act by:

A
  • inc intra-nephron solute conc (actual drug too)

* water remains IN nephron

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2
Q

Loop diuretics act by:

A
  • Na/Cl/K transporter –> out of nephron
  • Loop d block Cl movement and so stop all transporter
  • Na not reabs therefore water not either
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3
Q

Side effects of loop diuretics are

A

renin release due to reduced plasma volume, go against diuretic aim.

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4
Q

Name a osmotic diuretic

A

Mannitol

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5
Q

Name a loop diuretic

A

Furosemide

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6
Q

Where do osmotic diuretics act?

A

PCT and LoH

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7
Q

Name a thiazide diuretic

A

Hydrochlorothiazide

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8
Q

Action of thiazide diuretics?

A
  • inhib Na/Cl symporter in DCT
  • inc excretion of Na, Cl, K, and water
  • inc reabs of urea –> gout
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9
Q

Thiazides act where in the nephron?

A

DCT

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10
Q

Name 2 K-sparing diuretic

A

Spironolactone

Amiloride

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11
Q

There are 2 actions of K-sparing diuretic, name them.

A
  1. Aldosterone inhibition.

2. NaKATPase inhibition

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12
Q

Name an aldosterone inhib

A

Spironolactone

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13
Q

Name a Na/K exchanger inhib

A

Amiloride

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14
Q

Which type of cells are aldosteroe receptors found?

A

Intercalated cells of Coll. duct

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15
Q

Carbonic anhydrase inhibitors are the _______diuretic

A

weakest

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16
Q

Name a carbonic anhydrase inhib

A

Acetazolamide

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17
Q

Name the side effects of carbonic anhydrase inhibition

A
  • Metabolic acidosis - accumul of carbonic acid
  • hypokalaemia
  • V&D
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18
Q

What is the ultimate aim of diuretic treatments?

A

Sequential nephron blockade

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19
Q

To improve incontinence, the _____ NS needs stimulating

A

Sympathetic

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20
Q

What receptors increase sympathetic actions

A

A lpha
Beta
-increase in adrenergic sensitivity

21
Q

Using sympathetomimetics for unrinary incontinence is Contra-indicated when..

A

Patient has CV, Renal or hepatic impairment

22
Q

Preventing the stimulation of the detrusor would help incontinence. What antagonist would be required?

A

Anti-cholinergics (pre-gang synapse)

Anti-muscarinic (post gang)

23
Q

If urinary retention is the Dx, then using what can be effected?

A
  • Inc detrusor (Bethanecol)
  • decrease int sphincter contraction (prazosin)
  • inhib skeletal muscle ocntrol of ext sphincter (diazepam)
24
Q

Name four uroliths (bladder stones)

A
  1. Struvite
  2. Ca Oxalate
  3. Urate
  4. Cysteine
25
Q

Which stone treatment requires the urine to be acidified?

A

Struvate

26
Q

Name two methods to inc acidity of urine

A
  1. Methionine

2. Ammonium salts

27
Q

Ca oxalate, Urate and Cysteine crytals are treated by increasing pH of urine, how?

A

Na-bicarb

Na or K citrate

28
Q

What are the main clinical signs of renal failure

A
  • PU/PD
  • Azotaemia
  • anorexia
  • inc BP
  • Inc Blood phosphate
  • anaemia
29
Q

where is PTH secreted from?

A

parathyroid gland

chief cells

30
Q

What is hyperparathyroidism?

A

XS PTH

Rubber Jaw

31
Q

How are PTH levels regulated?

A
  • Calcitrol –> inc uptake of Ca from SI and puts in bones
  • Low blood Ca —> PTH release
  • PTH inc osteoclastic activity
  • inc reabsorption in kidney
32
Q

Treatment for kidney failure: diet changes, describe

A
  • low protein
  • high biol value
  • low P
  • high K
33
Q

What are phosphate binders used for?

A
  • CKD

* watch if high Ca++ which type used

34
Q

Bacterial cystitis treatments =

A

Non-metabolised antibiotic.

Penicillin

35
Q

What is the main cause of cystitis

A

Stress

36
Q

Penicillin used for cystitis may be adversely effected if the urine pH is too _____

A

High

37
Q

What % is saline

A

0.9% NaCl

38
Q

Name the 2 types of fluid solution

A
  1. crystalloid

2. colloid

39
Q

What % of water is in the ECF?

A

20%

40
Q

Crystalloid Solution

A
  • enter all compartments, v small
41
Q

Name 4 types of crystalloid solution

A
  • 0.9% NaCal
  • Hartmanns
  • 5% Dextrose
  • Hypertonic Saline (3% NaCl)
42
Q

Colloid solution:

A
  • large molecules cant go out of vessels
  • reduce oedema
    Types:
  • impairment
43
Q

Name 3 types of colloid solutions

A
  • Gelatin
  • anaphylaxis poss Starch
  • can correct dehydration, acidosis Dextrose
  • coagulopathies and renal impairment
44
Q

This solution has plasma-like balanced electrolytes. Lactate to treat acidosis and is good as maintenance fluid

A

Hartmann’s solution

45
Q

Hypertonic saline 3% is used when?

A

Treating oedema. Use carefully! dehydration easily caused!

46
Q

Fluid calculations need to consider 3 things:

A
  1. Deficit
  2. On going losses
  3. Maintenance
47
Q

Replacement volume

A

= % Dehydration x Bodyweight (kg) x 10

48
Q

Ongoing losses =

A

= Amount per loss (ml/kg) x Bodyweight (kg) x No. of losses

49
Q

Maintenance fluid rate

A

= 2ml/kg/hr

VSCI200 NSF (25 decks)

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