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Diuretics | Pharmacology | Dr Najeeb
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Diuretics-Pharmacology
00:00:00
Diuretic and Natriuretic.
00:02:02
Relationship between Cardiac Output (CO) and Renal Blood Flow (RBF), Percentage of RBF ending up as Filtrate; Concept of Glomerular Filtration Rate (GFR) as a function of CO and RBF. Understanding the role of processes such as Filtration, Reabsorption and Secretion.
00:16:19
Percentage ending up as Final Urine Volume, Clinical co-relate: Oliguria, Polyuria; Nephron as the "Master Processor".
00:28:59
Diuretic and Natriuretic drugs' action on nephrons.
00:30:26
Outline: Mechanisms and sites of Reabsorption (Na+ primarily), 1-Proximal Convoluted Tubule (PCT) 2-Thick part of Ascending Loop of Henle (TALOH) 3-Distal Convoluted Tubule (DCT) 4-Collecting Tubule (CT)
00:33:42
1-Proximal Convoluted Tubule (PCT); Anatomy of PCT & mechanisms of Reabsorption, Secretion, Exchange (Na+, H+, HCO3-), Role of Na+H+-counter transporter and Na+K+ ATPases.
00:50:00
Carbonic Anhydrase (CA) enzyme, H2CO3 (Carbonic Acid); [HCO3- and H+] and the drugs that act through blocking CA enzyme (CA inhibitors); Increased Na+, HCO3- and H2O in urine: Acetazolamide.
01:00:29
4-Collecting Tubule (CT) : Principal cells, Mechanisms of K+ wasting (Kaliuretic); K+ Wasters = All Diuretics acting proximal to CT.
01:13:00
Descending LOH: Freely permeable to H2O [along with PCT]; Ascending parts of LOH + initial DCT fully impermeable to H2O, Role of ADH in CT's water permeability and excretion of dilute and concentrated urine, Osmolarities in various parts of tubule & its rationale.
01:35:56
2-Thick part of Ascending Limb of Loop of Henle (TALOH); Na+ K+ 2Cl- Co-transporter, K+ leaky channels on luminal side; electro positivity in lumen and its effect on Ca+, Mg+ reabsorption; Drugs blocking NaKCl co-transporter; Loop Diuretics [Furosemide etc.]; Kaliuretic + Calcinuria + Magnesiumurea
02:04:15
3-Distal Convoluted Tubule (DCT): Na+Cl- co-transporter, Na+Ca+ counter transporter, role of Parathyroid hormone (PTH), Thiazide Diuretics as Ca+ retaining drugs; Renal stones.
02:19:15
Comparing Thiazide Diuretics, Furosemide and their effect on Ca+ absorption & its clinical implications; Osteoporosis, Hyperuricemia. Interaction with NSAIDS.
02:26:35
Drugs acting distally to DCT; Antikaliuretic drugs: Importance of Principal cells in K+ balance, Na+ channel blocking drugs, Role of Aldosterone;
02:48:50
Effects of Diuretics on Principal Cells; Amiloride, Triamterene; K+ Sparing drugs. Aldosterone Receptor Blockers (ARBs): Spironolactone
02:54:54
Osmotic Diuresis; PCT: Mannitol; Increased Extracellular Fluid Volume (ECFV)
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