Term
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Definition
Management of Edema:
Associated with Cardiovascular disorders
Renal
Endocrine abnormalities
Treatment:
Hypertension
Glucoma |
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Term
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Definition
| Important site for tubular reabsorption and secretion. About 85% of filtered sodium bicarbonate is reabsorbed in to proximal tubule. Inhibited by carbonic anhydrase inhibitors |
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Term
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Definition
Reabsorption of 35% of filtered sodium chloride
Reabsorption is inhibited by loop diuretics
(this diuretic effect is greater than any other effect) |
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Term
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Definition
| Early distal tubule – reabsorption of 5-10% of filtered NaCl (inhibited by thiazides) |
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Term
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Definition
Serves to adjust final composition and volume of urine. Extracellular fluid and pH
Site of action: Aldosterone antidiuretic hormone |
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Term
| Sites of Action of Diuretics |
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Definition
From glomerulus, ultrafiltrate travels to proximal convoluted tubule (PCT) (1),
then to the loop of Henle (2), (thin descending limb (TDL), ascending thin limb (ATL), medullary thick ascending limb (MTAL), and cortical thick ascending limb (CTAL) of Henle.
The distal convoluted tubule (DCT) (3) includes the macula densa and juxtaglomerular (JG) apparatus.
The collecting duct (4) consists of
cortical collecting duct (CCD),
outer medullary collecting duct (OMCD), and inner medullary collecting duct (IMCD). |
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Term
| Carbonic anhydrase inhibitors |
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Definition
| act at the proximal convoluted tubule |
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Term
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Definition
| act at the medullary and cortical thick ascending limbs |
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Term
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Definition
| inhibit solute transport in the distal convoluted tubule |
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Term
| Potassium-sparing diuretics |
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Definition
| inhibit collecting-duct Na+ reabsorption. |
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Term
| The Renin-Angiotensin–Aldosterone Axis pt.1 |
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Definition
| First, angiotensin II stimulates zona glomerulosa cells of the adrenal cortex to secrete aldosterone, which increases renal NaCl reabsorption at multiple segments along the nephron |
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Term
| The Renin-Angiotensin–Aldosterone Axis pt. 2 |
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Definition
| Second, angiotensin II directly stimulates renal proximal tubule reabsorption of NaCl |
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Term
| The Renin-Angiotensin–Aldosterone Axis pt. 3 |
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Definition
| Third, angiotensin II causes efferent arteriolar vasoconstriction, an action that increases intraglomerular pressure which increases GFR |
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Term
| The Renin-Angiotensin–Aldosterone Axis pt.4 |
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Definition
| Fourth, angiotensin II stimulates hypothalamic thirst centers and promotes ADH secretion |
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Term
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Definition
| proximal convoluted tubule |
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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
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Definition
| medullary thick ascending limb |
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Term
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Definition
| cortical thick ascending limb |
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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
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Definition
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Term
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Definition
| outer medullary collecting duct |
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Term
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Definition
| inner medullary collecting duct |
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Term
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Definition
inhibit sodium chloride reabsorption from distal tubule.
Primary use: treat hypertension, edema, hypercalciuria, diabetic insipidus |
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Term
| Potassium sparing diuretics |
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Definition
inhibit potassium secretion in to collecting duct (used to prevent hypokalemia)
Spironolactone is used for heart failure and hyperaldosteronism |
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Term
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Definition
increase osmotic pressure of plasma and retain water in the nephron
Used to treat cerebral edema, glaucoma |
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Term
| Carbonic anhydrase inhibitors |
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Definition
| are weak diuretics, inhibit sodium bicarbonate reabsorption from proximal tubule |
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Term
| Antihypertensive actions of thiazide diuretics |
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Definition
Initially, thiazide diuretics decrease blood volume and thereby decrease cardiac output.
Over time, the drugs decrease PVR, an action that may be secondary to a reduction in the sodium content of smooth muscle cells.
PVR = peripheral vascular resistance. |
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Term
| Adverse effects of thiazide diuretics |
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Definition
Inhibition of uric acid secretion in the proximal tubule can lead to hyperuricemia and gout.
Increased potassium secretion in the collecting duct can cause hypokalemia.
Hypokalemia can lead to metabolic alkalosis by promoting the exchange of intracellular potassium for hydrogen ions and by increasing the excretion of hydrogen ions.
The increased excretion is caused by lack of availability of potassium for exchange with sodium in the collecting duct.
In the presence of hypokalemia, the amount of insulin secreted by the pancreas can be reduced, thereby leading to hyperglycemia
Other mechanisms can also be involved in the development of hyperglycemia |
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Term
| Dose-response curves of loop and thiazide diuretics |
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Definition
Loop diuretics produce dose-dependent diuresis throughout their therapeutic dosage range
Thiazide diuretics have a relatively flat dose-response curve and a limited maximal response |
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