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Pharmacology > Week 3 renal > Flashcards

Week 3 renal Flashcards

1
Q
A

a) kidney
b) Ureters　尿管
c) Bladder
d) Urethra　尿道

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2
Q
A

1) Glomerular
2) Proximal Tubule 60-70% Na + H2O
3) Loop of Henle / descending
4) Loop of Henle /ascending 20-25%
5) Distal tubule 5-10%
6) Collecting ducts ADH

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3
Q

Tubular reabsorption vs tubular secretion

A

Reabsorption Back to blood
Secretion Blood to tubule

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4
Q

a) Glomerulus:?

b) Afferent arteriole?

c) Efferent arteriole:

A

a) Place where exchange/filtration occurs between the circulatory and urinary systems
b) brings blood to the nephron
c) takes blood back to the body ** Think A before E in terms of where they lie in relation to the glomerulus ***

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5
Q

What substances reabsorb?

A

Body excretes ALL creatine

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6
Q

Condition causing fluid overload? 5

A

Heart failure(very common)
Liver diseases
Kidney diseases
Hyperaldosteronism
Corticosteroid therapy

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7
Q

Diuretics how to work? 3

A

Drug inc rate of urine production

Drug reduces extracellular fluid volume

Drug blocks reabsorption of Na (water follows Na)

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8
Q

Thiazide diuretics

Medications name

A

Hydrochlorothiazide
Chlorothiazide
Chlorthalidone
Metolazone
Indapamide

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9
Q

Thiazide diuretics

a) act on where?
b) Inhibit what?

A

a) distal convoluted tubules
b) Sodium reabsorption

Sodium carry water, so inhibit this
Urine output increase
K excreted (排出）

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10
Q

Thiazide diuretics

Limitation

A

Oral dosage only
Can only affect 10% of sodium load
Loose effect after 1-2 weeks

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11
Q

Why Thiazide-induced hypokalemia?

A

More pee=more lose K

Muscle weakness and cramps
Cardiac arrhythmias 不整脈

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12
Q

Loop diuretics

Medications name

A

Furosemide (Lasix)
Bumetanide
Torsemide

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13
Q

Loop diuretics

a) act on where?
b) Inhibit what?

A

a) ascending Loop of Henle
b) Sodium reabsorption

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14
Q

Loop diuretics

Advantage

A

Most effective diuretic (20-25%)
Oral and IV forms
High ceiling diuretics

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15
Q

Loop diuretics

indication

A

Moderate/severe edema
HTN from volume overload

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16
Q

Thiazide and loop diuretics

ADRs

A

Hypokalemia (normal 3.5-5)
Hyperglycemia
Calcium wasting (loop only)
Ototoxicity (Loop only)

Dehydration (total volume water)
Hypovolemia (too low water in blood)

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17
Q

Nursing intervention for thiazide and loop 3

A

Monitor BP often
Changing position
Fall risk elderly

18
Q

Potassium-Potassium-Sparing

a) act on where?
b) What action?

A

a) Distal tubule
b) Block sodium channels
Prevent secretion of K

19
Q

Potassium-Potassium-Sparing

Medication name

A

Amiloride
Triamterene

Amiloride+ Hydrochlorothiazide= Moduretic
Triamterene+ Hydrochlorothiazide= Dyazide

20
Q

Potassium-Potassium-Sparing

limitation

A

Weak diuretics
Typically used in combination with thiazide diuretics
(to maintain neutral K balance)

21
Q

Potassium-Potassium-Sparing

ADR

A
  • *Hyperkalemia**
  • renal impairment
  • Diabetics
  • Elderly

Muscular weakness
Paralysis
Cardiac arrhythmias

22
Q

Aldosterone antagonists

a) act on where?
b) Inhibit what?

A

a) distal tubule and collecting duct
b) Blocking the action of aldosterone

Aldosterone= increase sodium reabsorption
ADH=only water

23
Q

Aldosterone and ADH work together to?

A

Increase water reabsorption

Aldosterone acts in the distill tubule
ADH works in collecting duct

24
Q

Aldosterone antagonists

Medications name

A

Spironolactone
Eplerenone

Spironolactone+ Hydrochlorothiazide = Aldactazide

25
Q

Aldosterone antagonists

a) indication
b) ADRs

A

a) Patients with increased levels of aldosterone
- Heart failure
- Live failure

b) Hyperkalemia
Hormonal effects (spironolactone only)
-gynecomastia
-breast tenderness

26
Q

Peripheral edema cause?

A

Results from inadequate water excretion 🡪 too much water is being reabsorbed
Can occur in legs, face, lungs, abdomen

27
Q

Osmotic diuretics, action?

A

“Water magnet”
In renal tubule– trap water in tubule to cause diaresis

In blood–draw blood from tissues into blood

  • cerebral edema
  • high intraocular pressure in glaucoma
28
Q

Osmotic Diuretics name

A

Glycerin
Mannitol
Urea

29
Q

Carbonic Anhydrase Inhibitors, name

A

Acetazolamide

30
Q

Carbonic Anhydrase Inhibitors

a) action b) used for

A

a) In tubule, Carbonic Anhydrase necessary for reabsorption of bicarbonate

  • without bicarbonate, sodium ions not reabsorption efficiently
  • result increased urine and alkaline urine

b) Edema
Glacoma
Some drug overdose

31
Q

Nursing considerations

diuretics meds

A

Administer in the morning
Other risk of hypovolemia
-diarrhea
-vomiting

Monitoring
-K
-Na
-BUN
Creatinine

32
Q

Creatinine clearance

Normal
Mild impairment
Moderate impairment
Sever impairment

A
33
Q

What thiazide primary used for?

A

HTN

34
Q

Which meds are ADR of hypokalemia?

a) hydrochlorothiazide
b) torsemide
c) amiloride
d) spironolactone
e) acetazolamide

A

c, d

35
Q

In which part of the nephron does the most sodium and water reabsorption take place?

A

Proximal tubule 60-70%

36
Q

Dehydration, hypovolemia and hypokalemia are all ADR of which drug?

a) Furosemide
b) Amiloride
c) Eplerenone
d) Metolazone
e) Mannitol
f) Chlorthalidone
g) Torsemide

A

a,d,f,g

37
Q

Which of the following is the primary use for Acetazolamide?

a. Hypertension
b. Glaucoma
c. Edema
d. Cataract

A

b

38
Q

Which of the following drugs action is not to cause diuresis but to move fluid from one place to
another?

a. Glycerin
b. Acetazolamide
c. Eplerenone
d. Metolazone

A

a

39
Q

Which of the following is an adverse reaction of Spironolactone?

a. Orthostatic hypotension
b. Hypovolemia
c. Ototoxicity
d. Erectile dysfunction

A

d

40
Q

You would need to educate patients about excessive potassium intake due to the risk of hyperkalemia
for which of the following drugs? (Select all that apply)

a. Hydrochlorothiazide
b. Torsemide
c. Amiloride
d. Spironolactone
e. Acetazolamide

A

c, d

Pharmacology (34 decks)

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