Term
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Definition
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Term
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Definition
| increase in renal Na excretion and thus water excretion (diuretic) |
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Term
| define diuretic and function |
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Definition
inhibits ion transport and decreases Na transport in nephron
manage fluid retention (edema), tx HTN |
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Term
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Definition
filtered in glomerulus and not reabsorbed
causes osmotic attraction of water (not Na) to tubular lumen |
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Term
| mannitol location of action 3 |
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Definition
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Term
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Definition
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Term
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Definition
maintain urine flow during toxic ingestion of substances causing renal failure
reduce increased ICP
lower pressure in acute glaucome
rhabdomyolysis: severe muscle injury to eliminate myoglobin |
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Term
| what are the 6 types of K supplements and their adlministration |
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Definition
K-DUR: KCl tablets
K-LOR: KCl powder
K-LYTE/CL: KCl tablets
K-TAB: KCl tablets
KLOTRIX: KCl tablets
KAO lectrolyte: fluid and electrolyte replacement |
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Term
| what is KAO lectrolyte made of 6, when is it used |
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Definition
dextrose, Na, K, citrate, calories, phenylalanine
mild/moderate diarrhea/vomiting |
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Term
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Definition
hepatic ascites: accumulation of fluid in abdomen
hyperALD: primary, secondary, decreased ability of liver to inactivate
nephrotic syndrome: glomerular membrane damaged and allows protein through decreasing colloid osmotic pressure
premenstural edema: increased estrogen causes loss of fluid into ECF |
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Term
| causes of hepatic ascites |
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Definition
| cirrhosis causes portal system obstruction and decreased colloid osmotic pressure |
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Term
| what are the drugs that work on the PCT 4 |
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Definition
acetazolamide
brinzelamide
dorzolamide
methazelamide |
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Term
| what are the drugs that work on the loop of henle |
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Definition
loop diruetics-
bumetanide
furosemide
torsemide
etharcynic acid |
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Term
| thiazide diuretics and analogs 4 |
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Definition
hydrochlorathiazide
chlorthalidone
metazone
indapamide |
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Term
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Definition
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Term
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Definition
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Term
| describe the cells of the PCT |
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Definition
tall
microvili
basla invaginations
interdigitated borders |
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Term
| explain how the PCT regulates acid/base |
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Definition
CA changes bicarbonate+H from urine into CO2+H2O which can diffuse into the cell
CA turns it back into bicarbonate+H
H is sent back to urine with Na/H antiporter
bicarbonate uses facillitated transport to enter the blood |
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Term
| other than the pumps for acid base regulation, what other transport is happening in the urine |
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Definition
Na/glucose, AA, lactate, HPO4 symporter from lumen to blood
Na/K ATPase on blood side
60% of H2O diffuses into blood
organic anions and cations diffuse into urine |
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Term
| what organic anions 3 and cations 3 diffuse into urine in PCT |
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Definition
diuretics
antibiotics
uric acid
creatinine
procanamide
choline |
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Term
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Definition
carbonic anhydrase inhibitior makes it so bicarbonate cannot form CO2+H2O and diffuse into the cell causing metabolic acidosis
there isnt enough H to run the Na/H pump so Na also stays in the urine and draws water (Weak diuretic)
Cl is retained in the blood causing hyperchloremia |
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Term
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Definition
DOC chronic glaucoma
acute mountain sickness prophylaxis
seizure adjunct medicing |
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Term
| how is acute mountain sickness treated, what are the symptoms |
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Definition
5d prior to ascent
prevents weakness, SOB, dizziness, nausea, cerebral and pulmonary edema |
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Term
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Definition
hyperchloremic metabolic acidosis
renal stones (basic urine favors CaP)
sulfonamide allergies
hypokalemia |
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Term
| what exchange happens in the thin limbs of the loop of henle |
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Definition
thin limbs do not participate in reabsorption of Na
they are permeable to water which is impaired by mannitol and glucose |
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Term
| what drugs interact with loop diuretics |
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Definition
aminoglycocides
digoxin (decreases) |
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Term
| what are the channels of the thick loops |
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Definition
K/Na/2Cl symporter from urine to cell
K leak channel from cell to urine
Na/K antitiporter from cell to blood
K/Cl symporter from cell to blood
Mg+Ca charge driven transport paracellular from urine to blood |
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Term
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Definition
stop Na/L/Cl channel causing ion and water retention in ascending loop
increase Ca in urine because when Na/K/Cl transport is stopped there is no K build up and no leak which stops positive charge and Mg/Ca dont diffuse into blood |
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Term
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Definition
acute pulmonary edema (IV rapid onset, powerful)
CHF
HTN
nephrotic system edema
kidney failure edema |
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Term
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Definition
ototoxicity: tinnutis, vertigo, deafness, fullness (worse with amnioglucocides and etharynic acid)
hyperuricemial: WA competes for transport in PCT to stay in urine
acute hypovolemia: severe, rapid, shock, arrhythmia
orthostatic hypotension
hypokalemic acidosis
sulfonamide allergy |
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Term
| what is the most powerful diuuretic |
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Definition
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Term
| how much Na is reabsorbed in each portion of nephron |
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Definition
PCT 50%
loop 40%
DCT 10%
CD 5% |
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Term
| what carbonic anhydrase inhibitors are specific to IOP and used in OPEN angle glaucoma |
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Definition
brinselamide
derzelamide
methazolamide |
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Term
| why use a thiazide analog |
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Definition
| thizade diuretics dont work GFR <40 |
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Term
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Definition
simple cuboidal
impermeable to water |
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Term
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Definition
inhibits Na/Cl co-transporter and has some action on Ca in PCT
increased Na/Cl in urine pulls water
causes K loss because they increase delivery of Na to CD and Na/K channel causes K excretion
this alters balance of Na/Ca exchanger and increases Ca in the blood
decreases TPR and BP which can decrease CP and causes hypotension |
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Term
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Definition
HTN: decreases TPR wo major diuretic effect
CHF: decreases extracellular edema
edema: CHF, cirrhosis, kidney edema
hypercalcuria: good for CaOxylate stones
nephrogenic DI: cause hyperosmloar urine (act like ADH) |
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Term
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Definition
hypokalemic acidosis
hypercalcemia
orthostatic HTN
hyperlipidemia
sexual dysfunction
sulfonamide allergy
hyperuricemia: WA competes with uric A in PCT
hypoglycemia |
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Term
| why do thiazides cause hypoglucemia |
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Definition
B cells K channels are normally open
diuretic causes loss of K so they stay open longer and dont make much insulin |
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Term
| what are the 4 transporters in the DCT |
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Definition
Na/Cl synporter from urine to cell
Ca channel from cell to urine
Na/K ATPase on blood side
Na/Ca antiporter with Na going from blood to cell |
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Term
| how is transport in the DCT regulated |
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Definition
| PTH regulates luminal Ca channels and apical Na/Ca antiporter |
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Term
| why do drugs cause K sparing |
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Definition
| they increase Na before the CD/CT and the concerntration sucks the K into the CD/CT when Na tries to get out in the exchanger |
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Term
| what are the channels on the luminal side of the principal cell 3 |
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Definition
Na into cell
N into lumen
water into cell |
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Term
| what are the channels/pumps on the apical side of the principal cell 2 |
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Definition
Na/K ATPase
H2O ALD controlled channels |
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Term
| what pericellular transport is there in the CD |
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Definition
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Term
| what are the transporters on the intercalated cells |
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Definition
ATP pump H into urine
Cl/bicarb antiporter putting bicarb into blood |
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Term
| what is the primary site of H secretion |
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Definition
| intercalated cells of the CD |
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Term
| how does ADH regulate the CD |
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Definition
| opens aquporin channels on apical side of cells |
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Term
| how does ALD regulate the CD |
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Definition
| increases activity in luminal Na and K channels buy increasing activity of Na/K ATPase putting K into urine and Na into blood |
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Term
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Definition
ALD receptor antagonists stimulate Na reabsorption into urine without K loss
spironolactone also blocks androgen receptors |
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Term
| uses of K sparing diuretics 4 |
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Definition
duiretic: low efficacy in Na mobalization
secondary hyperaldosteronism: cardiac failure decreases remodeling, cirrhosis, nephrosis
primary hyperaldosteronism: adrenal adenoma
female histurism: spironolactone only due to androgen blocking |
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Term
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Definition
spironolactone: P450 inducer and prodrug
spironolactone: gynacomastia in males, irregular menses (never give high dose chronically)
hyperkalemia
nausea, letharty, mental confusion |
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Term
| MOA triametrene and amiloride and use |
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Definition
block Na channels decreasing Na/K ATPase activity and thus retention of K (does not depend on ALD like spironolactone)
not as effective as diuretic so often combine with other diuretic to save K |
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Term
| SE Na channel blocking diuretics 2 |
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Definition
hyperkalemia
leg cramps (triameterene |
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