9.1 - Diuretics and drugs in Kidney Failure Flashcards Preview

ESA 5 - Pharmacology > 9.1 - Diuretics and drugs in Kidney Failure > Flashcards

Flashcards in 9.1 - Diuretics and drugs in Kidney Failure Deck (17):
1

In what instances are carbonic anhydrase inhibitors used? How do they work? Why arent they used more frequently?

  • Used for glaucoma
  • Not used due to risks of metabolic acidosis and hypokalaemia
  • Acts on PCT to prevent action of carbonic anhydrase

2

In what instances are osmotic diuretics used? How do they work? Why arent they used more frequently?

  • Used in cerebral or pulmonary oedema
  • not used as causes excessive water loss and hypernatraemia
  • Act to increase osmotic gradient in renal tubules

3

How do ADH antagonists work?

Works by preventing AQP2 from being placed on cell membrane, preventing the water from being taken out of the tubule

4

What are the 4 types of diuretics currently used?

Loop, thiazide, K sparing, aldosterone antagonists

5

Give an example loop diuretic. What is its MoA? What is its indications?

  • furosemide
  • acts on NKCC2 on thin ascending loop of henle.
  • Risk of hypokalaemia
  • indications - HF, liver failure

6

Give an example thiazide diuretic. What is its MoA? What are its ADRs? Indications? DDI?>

e.g. - chlorothiazide

MoA - Acts on NaCl symporter in DCT. Promotes Ca reabsorption

ADR - hypokalaemia, hypercalcaemia, hyperuricaemia, ED

Indications - HF, hypertension

DDI - Beta blockers, digoxin, steroids all increase risk of ADRs

7

Give an example K sparing diuretic. MoA? DDI?

e.g. - amiloride

MoA - ENaC in DCT and CD.

DDI - ACE inhibitor increases risk of hyperkalaemia

8

Give example aldosterone antagonists. MoA? Indications? ADR? 

e.g. - spironolactone

MoA - Inhibition of aldosterone results in less NaKATPase and ENaC synthesis

ADR - hyperkalaemia, gynocomastia

Indications - HF, hypertension, liver failure, hyperaldosteronism e.g. Conns syndrome

9

What drugs would you use for heart failure?

Loop or thiazide diuretic.

ACEi and/or Beta blockers

10

What drugs would you use for hypertension?

Thiazide or aldosterone antagonists

ACEi and/or CCBs

11

What drugs would you use for liver failure?

aldosterone antagonist and loop diuretic

12

What are 4 physiological functions of the kidney?

REEM

Regulatory, Excretory, Endocrine, Metabolism

13

What are the regulatory functions of the kidney?

Fluid balance, acid base balance, electrolyte balance

14

What are the excretory functions of the kidney?

Waste products, drug elimination

15

What are the endocrine functions of the kidney? 

Renin-angiotensin-aldosterone, erythropoetin, prostaglandins

16

What are the metabolic functions of the kidney?

Vitamin D, polypeptides (insulin and PTH)

17