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19 Cards in this Set
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504 EXAM 3 RENAL DRUGS
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504 EXAM 3 RENAL DRUGS
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Primary and secondary uses of diuretics:
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Primary:
1. diuresis of expanded volume conditions (heart failure, cirrhosis, nephritic syndromes). 2. Anti-Hyptensive Secondary: Glaucoma, acute mountain sickness, metabolic alkalosis, poison detox, reducing extracellular vol. |
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What determines GFR?
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Intraglomerular hydrostatic pressure
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ACETAZOLAMIDE's effect on proximal tubule
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1. impairs bicarb reabsorption causing metabolic acidosis.
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Use of ACETAZOLAMIDE
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Prevents/treats high altitude sickness
Treats glaucoma |
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Organic acid and base secretion occurs where in the nephrone?
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Proximal tubule
Important mechanisms in drug and metabolites elimination. |
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Descending loop of henle is only permeable to:
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Water
Impermeable to filtrate solutes |
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What is the most significant site of action for MANNITOL in the nephron?
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Descending loop of henle
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What is MANNITOL and its function?
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Osmotic diuretic
Function: reduces osmotic gradient between interstitium and filtrate, reducing driving forces of water reabsorption. |
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Uses of osmotic diuretics?
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Reduces ECF vol. to reduce swelling (head trauma) or to increase renal blood flow (acute renal failure).
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Ascending loop of henle is enriched with what type of transporters?
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NaKCl co-transporter
Electroneutral: two Cl ions are taken up per Na/K pair. |
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The potential differential across the cell layer of the Ascending loop provides what function?
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The driving force for Ca and Mg reabsorption via paracellular mechanisms.
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Main use of FUROSEMIDE (LASIX) is?
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For rapid diuresis of vol. expanded states.
Inhibits NaKCL(2) co transporters. |
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What symporter activity does the distal tubule express?
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Na/Cl
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Which drug inhibits the Na/Cl symporter?
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Thiazide diuretics
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What is the main use of THIAZIDE?
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Anti-hypertensive
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TRIAMTERENE and AMILORIDE
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Inhibit Na channels
Are K+ sparing diuretics Used to reduce potassium wasting. Treat heart failures too. |
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The effect of diuretics on Na and K movement:
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Increased Na load delivered to CD leads to greater K+ secretion from cells in the CD.
Responsible for K wasting and hypokalemia. |
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LASIX
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Most powerful diuretics
It works at a site where significant capacity for solute reabsorption occurs. NOTE: drugs that work more distally, i.e. thiazide, are less effective because the ascending loop has substantially completed the bulk of the reab. task. |