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Pharm Ch 26

Diuretic Drugs

Define: Afferent arterioles The small blood vessels approaching the glomerulus.
Define: Aldosterone A mineralcorticoid steriod hormone produced by the adrenal cortex that mediates the actions of the renal tubule in the regulation of sodium and potassium balance in the blood.
Define: Ascites An abnormal intraperitoneal accumulation of fluid (500mL or more) containing large amounts of protein and electrolytes.
Define: Collecting duct The most distal part of the nephron between The distal convoluted tubule and the ureters, which lead to the urinary bladder.
Define: Distal convoluted tubule The part of the nephron immediately distal to the ascending loop of Henle and proximal to the collecting duct
Define: Diuretics Drugs or other substances that tend to promote the formation and excretion of urine.
Define: Efferent arterioles The small blood vessels exiting the glomerulus. At this point blood has completed its filtration in the glomerul.us
Define: Filtrate The material that passes through a filter. In the case of the kidney, the filter is the glomerulus and the filtrate is the material extracted from the blood (normally liquid) that becomes urine.
Define: Glomerular capsule The open, rounded, and most proximal part of the proximal convoluted tubule that surrounds the glomerulus and receives the filtrate from the blood.
Define: Glomerular filtration rate The volume of ultrafiltrate extracted per unit of time from the plasma flowing through the glomeruli of the kidney
Define: Loop of Henle The part or the nephron between the proximal and the distal convoluted tubules.
Define: Glomerulus the cluster of kidney capillaries that marks the beginning of the nephron and is immediately proximal to the proximal convoluted tubule.
Define: Nephron The microscopic functional filtration unit of the kidney
Name the parts of the Nephron in anatomical order from proximal to distal. The glomerulus, proximal convoluted tubule, loop of Henle, distal convoluted tubule, and the collecting duct.
List the hypotensive mechanisms of diuretics Diuretics cause direct arteriole dilation, reduce: extracellular fluid volume, plasma volume, and cardiac output
True or false? The afferent arterioles send blood in to the Golmerulus and the efferent take blood away. True, Afferent = approach and Efferent = exit
True or False? 60%- 70% of sodium and water get resorbed into the blood stream at the proximal tubule. True!
True or False? Aldosterone regulates the active transport of sodium back into the bloodstream while excreting chloride and hydrogen ions. False, Potassium is excreted along with the hydrogen ions not chloride.
Name the five types of Diuretic drugs. Carbonic anhydrase inhibitors, Loop, Osmotic, Potassium-sparing, and Thiazide and Thiazide-like Diuretics
Name Indications for CAI diuretics. Treatment of High blood pressure, glaucoma, edema, High altitude sickness, and anti-epleptic
Which part of the Nephron reabsorbs 20-25% of the sodium and water? The ascending Loop of Henle
3% of the body's sodium and water is reabsorbed where? The collecting ducts
CAI's lose their effectiveness after how many days? 2-4 days
Allergy to what type of drug ingredient limits the use of diuretics? Sulfonamides (but commonly given to such patients)
What is the name of the most commonly used CAI diuretic? Acteazolamide (Diamox)
Name contraindications of CAI. Drug allergy, Hypoatremia (low sodium), Hypokalemia (low potassium), severe renal or Hepatic dsyfunction, adrenal gland insufficiency, and cirrhosis
True or False? Acteazolamide is used to treat edema caused by heart failure when other diuretic do not work? True.
Name commonly used Loop diuretics. Furosemide/Lasix (most common), Bumetanide/Bumex, Torsemide/Demedex
Are diuretics safe for lactating mothers and their infants? No, Use of diuretics in lactating women is not recommended.
List Adverse effects of CAI's Metabolic acidosis, hypokalemia(2 most common), anorexia, hematuria, Drowsiness, photosensitivity, urticaria, melena (blood in stool), and Paresthesias (numbness/tingling of skin)
Desribe Mechanism of action for CAIs' CAI block carbonic anhydrase enzyme leading to a decrease in the levels of H+ ions in renal tubules which leads to increases excretion of bicarbonate, sodium, water, and potassium.
Loop diuretics cause potent diuresis. What are the cardiovascular effects caused by large fluid loss? Reduced blood pressure, reduced pulmonary and systemic vascular resistance, reduced central venous pressure, reduced left ventricle end diastolic pressure
What are the metabolic effects of Loop diuretics? Sodium, Potassium, and Calcium loss.
Name indications of Loop diuretics. Edema (assoc. w/ HF, hepatic or renal disease)e.g. Ascites & pulmonary, hypertension, increase calcium excretion, HF resulting from diastolic dysfunction.
Name contraindications of Loop diuretics. Drug allergy, hepatic coma, severe electrolyte loss.
Common adverse effects of Loop diuretics. dizziness, headache, tinnitus, blurred vision, nausea, vomiting, diarrhea, agranulocytosis (not enough WBCs), thrombocytopenia(not enough platelets), neutropenia-not enough neutrophils), hypokalemia, hyperglycemia, hyperuricemia (too much uric acid)
Name most common Osmotic Diuretic? Mannitol (Osmitrol)
Loop diuretics affects decreased by what group of drugs? NSAIDs
Describe Mechanism of action of osmotic diuretics? Nonabsorbable, producing osmotic effect pulls water into proximal tubule, inhibits tubular resorption of water and solutes, producing rapid diuresis.
Name indications for Osmotic diuretics. Used for patients in first phase of acute renal failure, to promote excretion of toxic substances, reduce intracranial pressure, treatment of cerebral edema
Name adverse effects of osmotic diuretics. Convulsions, Thrombophlebitis (swelling of vein caused by a blood clot), Pulmonary congestion, headaches, chills, chest pains, tachycardia, blurred vision, and fever
Explain mechanism of action for Loop diuretics. They inhibit sodium and chloride resorption in the Loop of Henle. they also increase Renal prostaglandins which dilates the blood vessels and causes a reduction of peripheral vascular resistance
True or False? Mannitol made only be given by IV. True.
True or False? Furosemide made be given orally or by IV. True.
True or False? CAI's and Loop Diuretics interact with Digoxin and/or Corticosteroids to cause digitalis toxicity? True, the mechanism is Hyperkalemia.
True or False? Mannitol has multiple drug interactions. False, Mannitol has no known significant drug interactions.
Created by: zigzog