Page 114 - Physiology and Pathophysiology MNU 2024-2025 نظرى
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Clinical pharmacy 2024/2025                   Level 2 Pharm D                       Physiology and Pathophysiology (MD303)

                                                             Collecting Duct :under effect of ADH



            ▪  Medullary area impermeable to high [NaCI] that surrounds it :The  ▪  Permeable to H2O depends upon the presence of ADH.

                walls of the CD are permeable to H20.                                   When  ADH  binds  to  its  membrane  receptors  on  CD,  it  acts  via

            ▪  H2O is drawn out of the CD by osmosis :Rate of osmotic                   cAMP.

                movement is determined by the # of aquaporins in the cell               -  Stimulates  fusion  of  vesicles  with  plasma  membrane   ➔

                membrane.                                                                   Incorporates water channels into plasma membrane.


                                                                              Secretion


             K secreted from collecting duct (from Blood to urine) also from PCT                                   Proximal Tubule


            •  Secretion of substances from the peritubular capillaries into interstitial               Glucose and Amino Acid Reabsorption
                                                                                         •  Filtered glucose and amino acids are normally reabsorbed by the
                fluid.
                                                                                            nephrons.
                  Then transported into lumen of tubule ➔into the urine.
                                                                                         In PCT occurs by secondary active transport with membrane carriers.
            Allows the kidneys to rapidly eliminate certain potential toxins              ▪  Carrier mediated transport displays:
                                                                                                - Saturation.   & - Tm.
                                                                                         [Transported  molecules]  needed  to  saturate  carriers  and  achieve
                                                                                         maximum transport rate.

               Renal transport threshold:

               Maximum plasma [substance] that results in excretion of that substance in the urine.     Renal plasma threshold for glucose = 180-200 mg/dl.
                                                                             Electrolyte Balance

                                             +
                                          +
                                      +
                                                                -3
                                                       _
               •  Kidneys regulate Na , K , H , Ct, HC03 , and P04 .
                                        +
               •  Control of plasma Na  is important in regulation of blood volume and pressure.
                                         +
               •  Control of plasma of K  important in proper function of cardiac and skeletal muscles.
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