Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
61 Cards in this Set
- Front
- Back
Cardiac Output |
HR X Stroke Volume |
|
Preload |
Fluid in the heart |
|
Afterload |
Resistance of impedance the ventricle must overcome to eject it blood volume |
|
INOTROPY |
Contractility |
|
Autonomic regulation of Blood Pressure |
Parasympathetic (ACh) vagus decreases in HR Sympathetic (B1) input NE SA node in to increase HR |
|
3 Primary factors that determine the resistance to blood flow |
* Radius of blood vessels * Length of blood vessel * Viscosity of blood |
|
What has the greatest effect of on Blood pressure? |
Blood Vessle Diameter |
|
True or False Vessle diameter has the largest impact on Blood pressure? |
True |
|
True or False, Diuretics decrease BP? |
Yes |
|
Diuretics |
Decrease Blood Volume this Decreases BP |
|
What drugs act on Proximal Convoluted Tubules |
* Carbonic Anhydrase Inhibitor *Osmotic Diuretics |
|
What drugs are used in Descending LOH |
Osmotic Diuretics |
|
Drugs for Ascending LOH |
Loop Diuretics |
|
Drugs for Distal Convoluted Tubule |
Thiazides |
|
Where do Thiazides act in the kidney? |
Distal Convoluted Tubule |
|
Collecting Tubule and Duct |
K sparring diuretics |
|
Diuretics |
Most diuretics are renal ion inhibitors **They block reabsorption of ions thus causing them to pull water into the urine** -reduce BV -reduce BP |
|
Carbonic Anhydrase inhibitors |
MOA- inhibit Carbonic Anhydrase which **Proximal Tubule** |
|
T or F are carbonic anhydrase inhibitors considered weak diuretics |
True, because it works early in the Nephron! THESE CAN BE COMBINED WITH LOOP THIAZIDES |
|
Carbonic Anhydrase inhibitors drugs |
- Acetazolamide (Diamox) - Methazolamide (Neptazane) |
|
CAI Theraputic uses |
-Glaucoma * Decreases AH prouction - Psudotumor Cerebri * decrease Cerebral Spinal Fluid |
|
True or False, Diamox is a good treatment for Glaucoma? |
True Diamox or Acetazolamide, is a CAI that is used for Glaucoma |
|
Oral Hypotensive doses |
* generally a low start dose for Glaucoma (125-250mg) ***For psudotumor Cerebri the starting dose is generally much higher 500mg BID |
|
True or False, CAI are a good treatment for Metabolic Alkalosis |
True!! remember Acetazolamide causes the blood to have increased CO2 so itll make it more acidic |
|
Contraindications of CAI |
- Metabolic Acidosis - Hypokalemia (you excrete K) |
|
Osmotic Diuretics |
**In the thin Descending Loop of Henle -Mannitol -Urea |
|
True or False, Osmotic Diuretics stay in Renal Tubule? |
True **Osmotic Diuretics stay in Tubule and prevent reabsorption of water |
|
What do Osmotic Diuretics Do? |
They prevent the reabsorption of water |
|
What are some examples of osmotic diuretics? |
Mannitol and Urea |
|
Is Acetaszolamide a Osmotic diuretic? |
No it is a CAI |
|
MOA for Osmotic Diuretics |
Adds Mannitol to the urine causing an Osmolarity shift without having to use Na pumps. |
|
True or false Osmotic Diuretics are reliant on Na Channels? |
False, they add Mannitol in the urine which cant be reabsorbed thus causing the osmotic gradient to shift |
|
Theraputic uses for Mannitol |
-Administered prophylactically for acute renal failure , CVD and nephrotic drugs * Short term Tx for Glaucoma *can lower Intracranial pressure |
|
Side effects of Osmotics |
*fluid and electrolyte imbalances * dehydration *Glycerol can cause Hyperglycemia in DM pts |
|
LOOP DIURETICS (SOO MUCH PISS) |
***FUROSIMIDE (LASIX)*** |
|
Furosemide is acts on what part of the Nephron? |
Thick Ascending Loop of Henle |
|
MOA of Loop Diuretics |
Block the Na and K Co-transporter which increases the Salts and H20 in urine |
|
What do Loop Diuretics do? |
they block the Na, Cl and K pump from the urine to the cell causing salts to stay in the urine and draw more water |
|
Theraputic uses for Loop Diuretics |
REDUCE BLOOD PRESSURE -Acute Pulmonary edema -Hypercalcemia and HyperKalemia |
|
How do Loop diuretics treat Hypercalcemia and Hyperkalemia? |
Loop diuretics cuase K and Ca to stay in the urine and get pissed away |
|
Adverse effects of Loop diuretics |
*Ototoxicity *gout due to Furosemide binding to uric acid transporters thus reducing uric acid secretion *acute hypovolemia and BP *Metabolic alkalosis *Hyperglycemia (not enough K to bind to insulin ) |
|
Thiazides |
****FIRST LINE OF DEFENSE***** -Low ceiling diuretic (low dose does nothing) *Chlorothiazide * Hydrochlorothiazide |
|
Where do Thiazides act? |
Distal convoluted tubule **remember this is where 25%of Na is exchanged |
|
What is the MOA of thiazides medications? |
Block reabsorption of Na/Cl in n the distal tubules thus letting Na and Cl pass into the collecting ducts which water will follow |
|
True or false, Thiazide medications are a high ceiling diuretic that act in the distal convoluted tubules and block Na and Cl reabsorption? |
False, Thiazides are a low ceiling medications which means even at high doses, you wont get a high response |
|
Full MOA of Thiazides |
Blocks Na Cl cotransporter. this decreases the amount of Na in the cell causing Na K pump to slow down and cause Na to be pumped into the blood in exchange for Ca. Then Ca will be pumped into the urine * INCREASES BLOOD Ca* |
|
Thiazides effects |
*can cause Vasodilation |
|
Thiazide theraputic uses |
**Decreases blood volume and vasodilation -enhances ACE inhibitors **Hypercalciuria- Increases the amount of Ca in the blood |
|
Side Effects of thiazides |
* hypercalcemia * hyperuricemia (increases Uric acid in the blood) * Increase Plasma lipids ***REMEMBER THESE ARE SULFA DRUGS SO THEY SHOULD NEVER BE GIVEN TO A PT WITH SULFA ALLERGIES**** |
|
Where can thiazides be excreted? |
Breast milk |
|
Hypovolemia could be caused from what medication? A. Mannitol B. Thiazide C Acetazolamide D. Furosemide |
B. Thiazide remember Thiazides act on the Distal Convoluted tubules thus causing vasodilation and increases blood Ca with osteoporosis |
|
Thiazide like medications |
*Chlorothalidone * metazolone - Metozalone can cause Na secretion even in advanced renal failure |
|
Potassium Sparing Diuretics ** Aldosterone Antagonists** |
Spironolactone |
|
Aldosterone antagonists |
*reduce production/activity of na/k Channels -basically increases Na in urine and decreases Na absorption ***EFFECTS ENDOCRINE -These have a low efficacy to mobilize Na from the body |
|
d |
d |
|
What is the MOA of CAI |
They inhibit carbonic Anhydrase **remember carbonic Anhydrase pumps Na in and H- out. The H- in the urine combines with HCO3 and gets transported into the cell Lumen This increases urine pH and keeps Na in urine thus pulling water into the urine **BLOOD ACIDOSIS*** |
|
True or False, Carbonic Anhydrase pumps Na into the Urine and H- into the urine? |
False, Carbonic Anhydrase pumps Na into lumen and H- into Urine which then binds to HCO3 |
|
What drug is a Carbonic Anhydrase inhibitor? And which portion of the Kidney does it effect? |
Acetlyzolamide, This Acts on the Proximal convoluted Tubule |
|
True or False Carbonic Anhydrase inhibitors can lead to blood Acidosis |
True |
|
Theraputic uses for CAI |
*Glaucoma- decreases AH production *Psudotumor Cerebri |
|
D |
D |