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Respiratory and urinary > Urinary pharmacology > Flashcards

Urinary pharmacology Flashcards

1
Q

What do diuretics do? How do they work?

A

Increase output of urine

Excrete sodium and water to prevent retention

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2
Q

Diuretics can be direct or indirect. How do these diuretics work?

A

Direct - acts on cell of the nephron

Indirectly - modify filtrate content

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3
Q

What is a common problem with diuretics? Why?

A

Hypokalaemia

Potassium lost with sodium

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4
Q

What are the 5 groups of diuretics?

A 
Osmotic diuretics
Potassium sparing diuretics
Loop diuretics
Carbonic anhydrase inhibitors 
Thiazides
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5
Q

Are osmotic diuretics direct or indirect? How do they work?

A

Indirect
Alter concentration of filtrate - they are filtered through the glomerulus but not reabsorbed so alter osmotic pressure in the nephron

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6
Q

What effect does an increased amount of filtrate have on sodium reabsorption?

A

Increased filtrate = less sodium reabsorption

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7
Q

Give an example of an osmotic diuretic?

A

Mannitol

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8
Q

How are osmotic diuretics administered?

A

IV

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9
Q

What are osmotic diuretics used for?

A

Olguric renal failure (can’t urinate)
Cerebral oedema
Glaucoma
Forced diuresis if poisoned

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10
Q

What is a side effect of an osmotic diuretic?

A

Initial increase in ECF

Can worsen oedema or cardiac failure

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11
Q

Where is carbonic anhydrase? What is the function of carbonic anhydrase?

A

In PCT, eyes and RBCs

Dissociates carbonic acid to produce H+

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12
Q

How do carbonic anhydrase inhibitors work? How is ionic balance maintained?

A

Inhibit carbonic anhydrase
Decrease H+ production and reduced Na/H+ exchange
Cl- retained to maintain ionic balance

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13
Q

What affect do carbonic anhydrase inhibitors have on the pH of urine?

A

Make it alkalotic

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14
Q

How are carbonic anhydrase inhibitors administered?

A

Orally

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15
Q

What are carbonic anhydrase inhibitors used to treat?

A

Oedema

Not used directly as a diuretic but have that effect

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16
Q

What are the adverse effects of carbonic anhydrase inhibitors?

A

Metabolic alkalosis

PUPD

17
Q

When can’t carbonic anhydrase inhibitors be used and why?

A

Liver disease

Alkaline urine means NH4 produced in kidneys goes into circulation

18
Q

Which diuretics are the most powerful?

A

Loop diuretics

19
Q

How do loop diuretics work?

A

Inhibit Na/K/Cl ransport in the LOH
Increase delivery of Na to DCT
Increase excretion of K, H+, Mg and Ca2+

20
Q

How are loop diuretics administered?

A

Orally

Parenterally

21
Q

What are loop diuretics used to treat?

A

Oedema

Congestive heart failure

22
Q

What are the adverse effects of loop diuretics?

A

Dehydration
Hypovolaemia if no water access
Hypokaelmia
ECF disturbances

23
Q

Thiazides are less powerful diuretics. Why are they still used?

A

Less side effects
Oedema
Dissolution of calcium containing bladder/kidney stones

24
Q

How do thiazides work?

A

Inhibit Na/Cl co-transport before aldosterone stimulated Na/K exchange
Increase Na, Cl, Mg and K excretion
Decrease calcium excretion

25
Q

Are loop diuretics more powerful diuretics than thiazides? Why?

A

Loop diuretics more powerful

Majority of Na has been reabsorbed in thiazides

26
Q

What are the adverse effects of thiazides?

A 
Hypokalaemia
Dehydration 
Hypovolaemia if no water access
ECF disturbances (less severe than loop diuretics)
Hyperglycaemia
27
Q

How are thiazides administered?

A

Orally

28
Q

Are potassium sparing diuretics powerful? When are they used?

A

Not when used alone

Used with loop diuretics and thiazides to prevent hypokalaemia

29
Q

How do potassium sparing diuretics work?

A

Affect Na but not K

2 ways: competitive inhibitors of aldosterone or inhibitors of Na reabsorption (therefore more Na/K/ATPase activity)

30
Q

What are the adverse effects of potassium sparing diuretics?

A

Hyperkalaemia

31
Q

When should potassium sparing diuretics not be used?

A

Renal impairment
Diabetes
Metabolic acidosis
Don’t use more than one together!

32
Q

What are potassium sparing diuretics used for?

A

Oedema

Preventing hypokalaemia

33
Q

Why can different diuretics be used together?

A

Sequential nephron blockade - act at different points in the nephron

34
Q

How are potassium sparing diuretics administered?

A

Orally

Respiratory and urinary (8 decks)

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