Term
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Definition
binds a nuclear receptor that stimulates the production of Na-K-ATPases in the distal tubule/collecting ducts
Increases: water, sodium
Decreases: potassium |
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Term
Anti-diuretic hormone
(ADH)(vasopressin) |
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Definition
binds a membrane receptor and through a GPCR-cAMP pathway causes the phosphorylation of aquaporin channels that are inserted in the late tubule/collecting ducts
Increases: water |
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Term
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Definition
| NKCC2 moves Na K Cl into cells and K leaks back out which builds up a positive charge and drives Ca reabsorbtion |
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Term
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Definition
class - carbonic anhydrase inhibitor
MOA - inhibits CA which normally converts bicarb/H+ to H2O/CO2
where: proximal tubule, eyes
Decreases: water, bicarb, sodium, potassium
Decreases: GFR, renin, and BP
Tx - glaucoma
AE - acidosis, kidney stones (nephrolithiasis), low K+ |
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Term
hydrochlorothiazide
(Esidrex) |
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Definition
class - thiazide diuretic
MOA - inhibits Na-Cl cotransporter (NCC) which normally reabsorbs these salts
where: distal convoluted tubule
Increases: calcium
Decreases: water, sodium, potassium
AE - hyopkalemia, gout, increased lipids
X - NSAIDS |
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Term
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Definition
class - loop diuretic
MOA - inhibits Na-K-Cl cotransporter (NKCC2) which normally reabsorbs these salts
where: thick ascending limb in the Loop of Henle
Increases: GFR (prostaglandins/macula densa)
Decreases: water, sodium, potassium, calcium
AE - hypokalemia, gout, ototoxicity (balance/hearing loss)
X - NSAIDS |
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Term
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Definition
class - potassium sparing diuretic
MOA - inhibits Na channel (ENaC) which normally reabsorbs Na
where: late tubule/collecting duct
Increases: potassium, H+
Decreases: water, sodium
AE - hyperkalemia, acidosis |
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Term
spironolactone
(Aldactone) |
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Definition
class - aldosterone antagonist
MOA - blocks the action of aldosterone which normally increases H2O/Na and decreases K
*works on capillary side unlike the previous drugs
where: collecting tubule (principal cells)
Increases: potassium
Decreases: water, sodium
AE - hyperkalemia, acidosis, gynecomastia (breast), hirsutism (hair) |
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Term
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Definition
class - ACE inhibitor
MOA - inhibits ACE which normally converts Ang1 to Ang2 (a vasopressor)
*note: alternate pathways exist to still produce Ang2
Increases: bradykinin, PG/renin
Decreases: aldosterone
AE - orthostatic HTN, hyperkalemia, cough
X - pregnancy |
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Term
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Definition
class - angiotensin receptor blocker
MOA - inhibit AT1 receptors which normally bind Ang2 and cause vasoconstriction
Decreases: aldosterone
AE - orthostatic HTN, hyperkalemia
X - pregnancy
NOTE - ARBs reduce the activation of AT1 receptors more effectively than ACEIs
NOTE - ARBs allow activation of AT2 receptors (vasodilate) |
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