PHRD6085 Pharmacotherapy Lecture 4 - Diuretic Pharmacology

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PHRD6085 Pharmacotherapy Lecture 4 - Diuretic Pharmacology
2014-08-25 05:23:19
Diuretic Pharmacology

Diuretic Pharmacology
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  1. 3 physiologic processes in the kidney
    • filtration
    • secretion
    • reabsorption
  2. sum of all 3 physiologic processes of the kidney
    renal clearance (CLrenal)
  3. functions of proximal tubule (3)
    • 1) reabsorption of water, Na, K, Ca, Cl, HCO3, glucose, AAs phosphate
    • 2) formation of vit D
    • 3) secretion of drugs & toxins
  4. what determines the final osmolality of urine?
  5. carbonic anhyrdrase inhibitor (acetazolamide) site of action
    proximal convoluted tubule
  6. loop diuretic (bumetanide, furosemide, torsemide, ethacrynic acid) sits of action
    ascending loop of Henle
  7. thiazide site of action
    distal convoluted tubule
  8. spironolactone & potassium sparing diuretics (amiloride, triamterene) site of action
    collecting tubule & duct
  9. inhibit passive reabsorption of water & transport processes inĀ thick ascending limb
    osmotic diuretics
  10. inhibits the formation of carbonic acid from CO2 & water resulting in a reduction of reabsorption of Na+ & HCO3- in the proximal tubule
    carbonic anhydrase inhibitors
  11. functions of Loop of Henle
    • generation of hypertonic medulla
    • dilution of urine
    • impermeabililty to water in thick ascending limb
    • transport of NaCl
    • Mg reabsorption
  12. most potent diuretics
    loop diuretics
  13. function of distal tubule
    • Na & Cl reabsorption
    • regulated Ca absorption
  14. most commonly used diuretics
  15. thiazide MOA
    inhibit Na+/Cl- minus symporter in distal convoluted tubule on luminal membrane
  16. function of collecting duct
    • final adjustment of urinary solute concentrations & osmolarity
    • K+ secretion
    • HCO3 regulation
  17. MOA of potassium-sparing diuretics
    • exchange Na+ & K+ through blockade of ENaC
    • mediate H+ secretion into tubule lumen
  18. MOA of spironolactone
    • mineralocorticoid R antagonist
    • inhibits transcription by blocking binding of aldosterone to MR
  19. clinical use of spironolactone
  20. clinical use of thiazides
    mild CHF