1516016434 | Bicarbonate diuretic? - whats the example? | A diuretic that selectively increases sodium bicarbonate excretion. e. g. carbonic anhydrase inhibitor | | 0 |
1516016435 | Diluting segment? What are the examples? | A segment of the nephron that removes solute without water. The thick ascending limb of the loop of Henle and the distal convoluted tubule are both diluting segments. | | 1 |
1516055415 | Hyperchloremic metabolic acidosis? Results from? | diminished bicarbonate concentration, and a decrease in blood pH. Typical result of bicarbonate diuresis | | 2 |
1516055416 | Hypokalemic metabolic alkalosis? Results from? | decrease in serum potassium and an increase in blood pH. Typical result of loop and thiazide diuretics. | | 3 |
1516055417 | Nephrogenic diabetes insipidus | Loss of urine- caused by a lack of responsiveness to antidiuretic hormone | | 4 |
1516055418 | Pituitary diabetes insipidus | Loss of urine- caused by a lack of antidiuretic hormone | | 5 |
1516055419 | Potassium sparing diuretic? Whats the example? | A diuretic that reduces the exchange of potassium for sodium in the collecting tubule; a drug that increases sodium and reduces potassium excretion. Example: aldosterone antagonist | | 6 |
1516055420 | Uricosuric diuretic? Whats the example? | increases uric acid excretion. Example: ethacrynic acid | | 7 |
1516055421 | The Kidneys do what? | 1. secrete renin to regulate blood pressure
2. secrete erythropoietin which stimulates red blood cell production
3.produce Calcitriol (active form of vitamin D) to help maintain bone homeostasis | | 8 |
1516055422 | What happens as Filtrate Travels Through the Nephron? | its Composition Changes | | 9 |
1516055423 | What do nephrons do? | Filtrate same composition as plasma minus large proteins in Bowman's capsule | | 10 |
1516055424 | Nephron absorption occurs how? And what is reabsorbed? | some substances in the filtrate pass through the walls of the neprhon and into the blood, most of the water in the filtrate is reabsorbed, glucose, amino acids, sodium, chloride, calcium and bicarbonate are reabsorbed | | 11 |
1516055425 | Nephron secretion occurs how? What is secreted? | some substances pass from the blood through the walls of the nephron and become part of the filtrate, potassium, phosphate, hydrogen and ammonium ion and many organic acids are secreted into the filtrate | | 12 |
1516055426 | Proximal Convoluted Tubule carries out? | isosmotic reabsorption of amino acids, glucose, cations, sodium and bicarb | | 13 |
1516055427 | Bicarb reabsorption is accomplished by? | converting bicarbonate to carbonic acid which dissociates to carbon dioxide. | | 14 |
1516055428 | What does the Thick Ascending Limb of Loop of Henle do? | Pumps Na, K, and Cl out of the lumen and into the interstitium of the kidney. | | 15 |
1516055429 | What does the Distal Convoluted Tubule do? | Actively pumps Na and Cl out of the lumen and into the interstitium. | | 16 |
1516055430 | Where is the Cortical Collecting Tubule? | ---final segment of the nephron and is the last tubular site of Na reabsorption --- is controlled by aldosterone | | 17 |
1516055431 | Cortical Collecting Tubule is the primary site of? | acidification of urine and of potassium excretion. | | 18 |
1516055432 | Most Diuretics Act by Blocking? | Sodium Reabsorption in the Nephron | | 19 |
1516055433 | Diuretics are useful in the treatment of? | heart failure, kidney failure, liver failure or cirrhosis, hypertension | | 20 |
1516055434 | Blocking re absorption sodium causes? | keeps more water in the filtrate =the greater the volume of urine | | 21 |
1516055435 | The Most Efficacious Diuretics are those that? | Affect the Loop of Henle | | 22 |
1516055436 | Loop Diuretics MOA | Block reabsorption of sodium and chloride in the ascending loop of Henle | | 23 |
1516055437 | Loop Diuretics are AKA? | high-ceiling diuretics because they produce a dose-dependent diuresis | | 24 |
1516055438 | Loop Diuretics are used to treat? | reduce edema associated with heart failure, hepatic cirrhosis, chronic renal failure (CrCl < 30ml/min), hypertension, and hyper-calcemia | | 25 |
1516055439 | Side effects of loop diuretics | 1. Increase the excretion of potassium, magnesium, and calcium
2. metabolic alkalosis
3. Increase blood glucose and uric acid
4. Ototoxicity, tinnitus, ear pain, and vertigo. | | 26 |
1516055440 | most commonly prescribed loop diuretic | Furosemide (Lasix) | | 27 |
1516055441 | Furosemide contra | sulfa allergy | | 28 |
1516055442 | only loop diuretic that is not a sulfonamide derivative | Ethacrynic acid. So if pt. is allergic to sulfa give this drug. It is More ototoxic than the other loop diuretics | | 29 |
1516055443 | most Widely Prescribed Class of Diuretics | Thiazides | | 30 |
1516055444 | Thiazides MOA | Block reabsorption of sodium at the early portion of the distal tubule and increase water excretion | | 31 |
1516055445 | Thiazides are used to treat? | mild to moderate hypertension | | 32 |
1516055446 | Thiazides side effects | 1.Increase potassium and magnesium excretion
2. Inhibit calcium excretion
3. hypokalemia, hyperglycemia, hyperuricemia, hyperlipidemia | | 33 |
1516055447 | Thiazides contra | sulfa allergy | | 34 |
1516055448 | Thiazides are not effective in patients with? And not as efficient as which diuretics? | severe renal disease (Creat. clearance < 30 mg/min). They are also Less efficacious than the loop diuretics | | 35 |
1516055449 | Potassium-Sparing Diuretics may help prevent? And they are not as effective as which diuretic? | Hypokalemia. However they are Less Efficacious than the Loop Diuretics | | 36 |
1516055450 | Potassium-Sparing Diuretics MOA Example of? | Block the exchange between sodium and potassium in the tubule causing sodium to stay in the tubule and leave through the urine
More potassium is retained by the body Example = spironalactone (aldactone) | | 37 |
1516055451 | spironolactone (Aldactone) actions | Inhibits aldosterone | | 38 |
1516055452 | spironolactone (Aldactone) adverse effects | hyperkalemia, gynecomastia and impotence | | 39 |
1516055453 | spironolactone (Aldactone) indications | Hypertension, CHF, Polycystic ovary disease, alcoholic cirrhosis, and hirsutism in women | | 40 |
1516055454 | Potassium-Sparing Diuretics interactions | ACE inhibitors or potassium supplements | | 41 |
1516055455 | Carbonic anhydrase inhibitors MOA | prevent formation of carbonic acid from water and carbon dioxide: causes bicarbonate diuresis and resultant metabolic acidosis. | | 42 |
1516055456 | acetazolamide (Diamox) indications. Is what type of drug? | angle glaucoma, altitude sickness and epilepsy (Is a Carbonyic Anhydrase Inhibitor.) | | 43 |
1516055457 | acetazolamide (Diamox) adverse effects | paresthesia | | 44 |
1516055458 | acetazolamide (Diamox) interactions | amphetamines, and quinidine | | 45 |
1516055459 | mannitol | very potent (Osmotic) diuretic; mannitol remains in the lumen and "holds" water The volume of urine is increased. | | 46 |
1516055460 | Mannitol indications | cerebral edema, acute glaucoma, acute renal failure, promote excretion of toxins | | 47 |
1516055461 | Mannitol adverse effects | Rapid volume expansion leading to pulmonary edema. HNV | | 48 |
1516055462 | Electrolyte Changes | chart on slide 55 | | 49 |
1516055463 | Conivaptan MOA | Arginine vasopressin (AVP), also called anti-diuretic hormone,Conivaptan is a V2-receptor antagonist; | | 50 |
1516055464 | Conivaptan Toxicity | HVD, thirst, hypokalemia, hypertension, and orthostatic hypotension. Rapid correction of serum sodium. | | 51 |
1516055465 | Conivaptan Interactions | CYP3A4. | | 52 |
1516055466 | Tolvaptan MOA | Antagonizes V2 receptors | | 53 |
1516055467 | Tolvaptan Toxicity | . GI bleeding has occurred in cirrhotic patients. | | 54 |
1516055468 | Tolvaptan Interactions | CYP3A | | 55 |
1516055469 | Acids and Bases can be Administered to maintain? | normal body pH | | 56 |
1516055470 | Acidosis and alkalosis can have? | serious or fatal consequences if not corrected quickly | | 57 |
1516055471 | a pH of 7.0 is | neutral | | 58 |
1516055472 | a pH above 7.0 is | basic or alkaline | | 59 |
1516055473 | a pH below 7.0 is | acidic | | 60 |
1516055474 | pH of plasma and most body fluids is | between 7.35 and 7.45 | | 61 |
1516055475 | Alkalosis develops at? | pH values above 7.45 | | 62 |
1516055476 | sodium bicarbonate treats? | shock, cardiac arrest, diabetes mellitus | | 63 |
1516055477 | sodium bicarbonate adverse effects | fluid overload, alkalosis | | 64 |
1516055478 | Electrolytes are? | small charged molecules that are essential to homeostasis
-nerve conduction
-muscle contraction
-bone growth and remodeling | | 65 |
1516055479 | Sodium electrolyte found where? Controlled by who? | extracellular fluid.. Sodium and water regulation are closely coupled and under dual control: ADH and Aldosterone. | | 66 |
1516055480 | Potassium found where? responsible for? | The major intracellular cation facilitates propagation of electrical impulses. | | 67 |
1516055481 | Calcium found where? responsible for? Controlled by who? | The most abundant mineral in the body. The gradient between the intravascular and extravascular ..which is maintained by parathyroid hormone and vitamin D. | | 68 |
1516055482 | Magnesium found where? responsible for? | intracellular. Magnesium promotes enzyme reactions within the cell during metabolism, helps in the production of ATP, participates in protein synthesis, and plays a role in coagulation, platelet aggregation, and neuromuscular activity | | 69 |
1516055483 | Chloride found where? | Chloride is a major extracellular anion | | 70 |
1516055484 | Intravenous Fluid Therapy Using Crystalloids and Colloids is Used to? | replace lost fluids | | 71 |
1516055485 | Causes of water and ion loss | hemorrhage
severe burns
diarrhea
vomiting
inadequate fluid intake | | 72 |
1516055486 | Intravenous fluid therapy is | the replacement of water and ions that have been lost | | 73 |
1516055487 | basic types of intravenous replacement fluids | Colloids
crystalloids | | 74 |
1516055488 | Intravenous Fluid Therapy adverse effects | Shock, dehydration or electrolyte loss may occur
Large fluid or electrolyte losses may be fatal | | 75 |
1516055489 | examples of colliods | plasma protein fraction (Plasmanate)
albumin (Albuminar)
dextran 40 (Gentran 40)
hetastarch (Hespan)` | | 76 |
1516055490 | colliods MOA | proteins or large molecules that stay suspended in the blood for long periods of time
draw water molecules from cells and tissues into the blood vessels-increase osmotic pressure
called plasma or volume expanders | | 77 |
1516055491 | crystalloids MOA | IV solutions that contain electrolytes in concentrations resembling plasma
leave the blood and enter cells
used to replace lost fluids and promote urine output | | 78 |
1516055492 | crystalloids examples | normal saline (0.9% sodium chloride)
lactated Ringer's
plasmalyte
hypertonic saline (3% sodium chloride)
5% dextrose in water (D5W) | | 79 |