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Subcommittee:
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NAME
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SCHOOL
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EMAIL
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Jack W. Strandhoy (Chair)
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Wake Forest University
School of Medicine
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jstrand@wfubmc.edu
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C. Paul Bianchi
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Thomas Jefferson University
School of Medicine
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David Loose-Mitchell
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University of Texas
Medical School at Houston
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- Review of Renal Physiology/Biochemistry (2)
- Diuretics (2)
a. Principles
and knowledge objectives:
1) List the major transporters and ion channels involved in renal
electrolyte transport. Describe their locations on the nephron and changes
that occur when specific diuretic drugs inhibit each one.
2) Explain the importance of the organic anion transport system and protein
binding to the renal action of diuretics. Provide examples of how other
drugs or diseases can interfere with the effects of diuretics.
3) Describe the renal and extrarenal mechanisms by which diuretics are
useful in treating hypertension and edema due to cardiac, endocrine,
hepatic, pulmonary or renal dysfunction. List appropriate drugs to be used
in each condition, including contraindications and limitations. Explain
when using combined diuretics may be useful.
4) Explain the consequences of diuretic therapy on alterations in glucose,
lipids, urate, calcium, magnesium and potassium. Where possible, describe
the underlying mechanism causing the adverse effect.
5) Explain the mechanism by which the thiazide and loop diuretics can cause
a metabolic alkalosis.
6) Explain how dopamine and mannitol increase renal blood flow and urine
flow. Describe their role in the prevention and treatment of acute renal
failure and toxic nephropathy.
7) Describe the clinical consequences of interactions between diuretics and
drugs such as cardiac glycosides, oral hypoglycemics, uricosurics,
aminoglycosides, amphotericin B, NSAIDs and ACE inhibitors.
- Agents Affecting the Renal Conservation of Water (1)
a. Principles
and Knowledge Objectives:
1) Describe the roles of vasopressin, aquaporins, V1 and V2
receptors, cyclic AMP, and prostaglandins in regulating renal epithelial
water permeability. Provide examples by which drugs interact with these
components to affect water reabsorption.
2) Compare and contrast the therapy of central and nephrogenic diabetes
insipidus.
3) Describe the mechanisms by which demeclocycline and lithium carbonate
interfere with renal water permeability. Describe the treatment of water
intoxication due to the syndrome of inappropriate ADH secretion.
4) Explain how diuretic therapy can lead to hyponatremia.
5) Outline the extrarenal uses of vasopressin.
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