kidneys

What does kidney do?

Remove soluble waste products from plasma, control extra cellular fluid vol, osmolarity and BP

Osmotic diuretic

Work on PCT

Mannitol, isosorbide, urea

Not reabsorbed too big

Draw fluid from cells and bring to kidneys, filtered along glomerulus and enter luman.

Creates osmotic gradient, mannitol in luman tubules h2o follows

More isotonic urine

Side effects:

Dehydration

Oedema

Carbonic anhydrase inhibitor

Pct

Azetazolomide

Works on na/k pump

Weak diuretic

Used in glaucoma

Side effects

Metabolic acidosis and electrolyte imbalance

Loop diuretic

Loop of henle

Furosemide

Inhibit NaCl reabsorption from ascending limb

Inhibit co transporter

Very potent

Rapid onset

Hypertension and pulmonary oedema

Side effects:

Hypokalaemia, oxotoxixity, dehydration

Thiazide diuretics

Dct

Sodium chloride cotranspoter inhibited

Na enters collecting duct

Chlorothiazide, hydrochlorothiazide

Side effects

Hyperglycaemia (loss of k)

Dose related changes

Weak diuretic hypokalaemia

Potassium sparing diuretic

Sprionolactone

Completes with aldosterone In collecting duct

Often used with other diuretics

Serum potassium levels must be monitored

Hyoerkalaemia (side effect)