Idiopathic
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I can...
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| mash
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hydrochlorothiazide
by causing sodium and water to be excreted by prox tubules
This leaves less fluid available for distal tubule to excrete -- (this is the portion affected by nephrogenic DI) -- and thus it limits the total volume of urine that can be excreted.
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| mash
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Ibuprofen or Indomethacin -- Inhibition of prostaglandin synthesis reduces delivery of solute to distal tubules, reducing urine volume and increasing urine osmolality.
Chlorpropamide -- Promotes renal response to ADH.
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| mdwannabe
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Thiazides...
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| hiwa
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desmopressin also can be used in emergency cases
what are the phrmacologicancauses of nephrogenic DI ?
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| intern_doc
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Demeocycline
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| mash
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Nephrogenic DI is caused by absence / unresponsiveness of ADH receptors in collecting duct.
or absent aquaporin, the protein that transports water at the collecting duct. As a consequence of one of these defects, the ducts do not respond appropriately to vasopressin.
desmopressin is CI in water loss due to NDI..
interndoc, wats the mech of action of demeocycline?
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| intern_doc
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Sorry, I dont remember the MOA of the drug. Stupid answer.....somehow demeocycline just pop into my head .....
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| Idiopathic
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demeclocycline is a mercury based diuretic that essentially kills the tubule. used in siADH, i think, caused by small cell CA, since those Px are terminal.
Thiazide is the DOC, and NSAIDS can help.
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| Idiopathic
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"mash" wrote:
hydrochlorothiazide
by causing sodium and water to be excreted by prox tubules
This leaves less fluid available for distal tubule to excrete -- (this is the portion affected by nephrogenic DI) -- and thus it limits the total volume of urine that can be excreted.
well, the correct mechanism is it stimulates the proximal tubule to reabsorb more, since it interprets it as a sodium loss (which can be helped earlier) rather than a water loss (which ADH helps, but not in this case). It is sort of a long-term negative feedback mechanism.
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| dariush
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well if you mean ANY Rxn at all, consider Lithium as well :wink:
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| mingle
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hey waitaminut...doesn't thiazides work on the distal tubules instead of the proximal? one book i thouhgt its desmopressin for central di democycline for conn's & thiazides for nephrogenic di...heh
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| mash
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oh yeah dat was a typo coz if it leaves less fluid available fr distal tubule to excrete dat implies there is more reabsorption in prox tubules..
anyways, thanx idiopathic.
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| dariush
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Plasmod3 : in fact, the effect of thiazides upon diabetes insi. is not related to its site of action. you see, in DI the problem is pure water excretion (w/o salts) that is why you need to drink all the time to compensate.now if you give thiazids they excret salt+water --> less total body salt content --> less increase in plasma osmolarity --> you dont have the urge to drink as much as you used to !!
(there you are, you broke the cycle of drinking urinating)
of course, thiazides are NOT a good choice for Central DI ; while you have Desmopressin for v2-R, why bother !?
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