{"podcast":{"title":"Channel Your Enthusiasm","slug":"channel-your-enthusiasm-1374325","podcast_index_feed_id":1374325,"rss_url":"http://www.rosebook.club/episodes/?format=rss","website_url":"http://www.rosebook.club/episodes/","image_url":"https://images.squarespace-cdn.com/content/v1/548bc7f6e4b0a269c594ebc2/1611689941077-BL32D22Z1P27G4UAVKEE/Screen+Shot+2021-01-26+at+2.34.41+PM.png?format=1500w","author":"joel topf","episode_count":31,"summary":"A chapter by chapter recap of Burton Rose’s classic, The Clinical Physiology of Acid Base and Electrolyte Disorders, a kidney physiology book for nephrologists, fellows, residents and medical students.","last_synced_at":null,"page_url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325"},"episode":{"title":"Chapter Fifteen: Clinical Use of Diuretics, part 1","slug":"chapter-fifteen-clinical-use-of-diuretics-part-1","published_at":"2024-05-13T23:18:12+00:00","page_url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325/chapter-fifteen-clinical-use-of-diuretics-part-1","show_page_url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325","url":"http://www.rosebook.club/episodes/2024/5/10/chapter-fifteen-part-1","audio_url":"https://chrt.fm/track/47G747/static1.squarespace.com/static/548bc7f6e4b0a269c594ebc2/t/6643d81125a37504af54a6b4/1723815734958/Chapter+15+part+1+Diuretics+fixed.mp3","summary":"Outline Chapter 15 — Clinical Use of Diuretics - Among most commonly used drugs - Block NaCl reabsorption at different sites along the nephron - The ability to induce negative balance has made them useful in multiple diseases - Edematous states - Hypertension - Mechanism of action - Three major classes - Loop - NaK2Cl - Up to 25% of filtered sodium excreted - Thiazide - NCC - Up to 3-5% of filtered sodium excreted - Potassium sparing - ENaC - Up to 1-2% of filtered sodium excreted - Each segment has a unique sodium channel to allow tubular sodium to flow down a concentration gradient into the cell - Table 15-1 is interesting - Most of the sodium 55-655 is reabsorbed in the proximal tubule - Proximal diuretics would be highly effective if it wasn’t for the loop and other distal sites of Na absorption - Loop Diuretics - Furosemide - Bumetanide - Torsemide - Ethacrynic acid - NaK2Cl activated when all four sites are occupied - Loop diuretic fits into the chloride slot - In addition to blocking Na reabsorption results in parallel decrease in calcium resorption - Increase in stones and nephro albinos is especially premature infants which can increase calcium excretion 10-fold - Thiazide - Even though they are less potent than loops they are great for hypertension - “Not a problem in uncomplicated hypertension where marked fluid loss is neither necessary nor desirable” - Some chlorothiazide and metolazone also inhibit carbonic anhydrase in the proximal tubule - Increase Calcium absorption. Mentions that potassium sparing diuretics do this also - Potassium sparing diuretics - Amiloride - Spironolactone - Triamterene - Act at principal cells in the cortical collecting tubule, - Block aldosterone sensitive Na channels. - Discusses the difference between amiloride and triamteren…","meta_description":"Outline Chapter 15 — Clinical Use of Diuretics - Among most commonly used drugs - Block NaCl reabsorption at different sites along the nephron - The abili…","key_points":[],"chapters":[],"topics":[],"duration_seconds":7256,"processing_state":"not_requested","actions":[{"name":"request_transcript","method":"POST","url":"https://stenobird.com/v1/public/podcasts/channel-your-enthusiasm-1374325/episodes/chapter-fifteen-clinical-use-of-diuretics-part-1/transcription-requests","description":"Idempotently request low-priority transcript generation for this episode."},{"name":"read_markdown","method":"GET","url":"https://stenobird.com/podcast/channel-your-enthusiasm-1374325/chapter-fifteen-clinical-use-of-diuretics-part-1.md","description":"Read the agent-friendly Markdown representation of this episode resource."}]}}