Free Water Clearance and diuretics pharmacology for NEET/USMLE/FMGE/PLAB

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6 жыл бұрын

Free Water Clearance and diuretics for NEET/USMLE/FMGE/PLAB
Free Water Clearance:
• Free water clearance is the amount of solute free water generated by the kidney.
• This solute free water is generated in the thick ascending limb and distal convoluted tubule, which are permeable to solutes but impermeable to water. Thus, this solute free water generated in the lumen is called as positive free water clearance.
• Solutes absorbed in thick ascending limb gives rise to medullary hyperosmolarity which absorbs the free water in collecting duct in response to vasopressin. Thus, here solute free water moves out from the lumen in to the body and this is known as negative free water clearance.
• Carbonic anhydrase inhibitors (acetazolamide) deliver more Na+ and water to thick ascending limb and distal convoluted tubule, where only Na+ is absorbed and water remains in lumen. Thus there is an increase in positive free water clearance.
• Loop diuretics (furosemide) and thiazides (chlorothiazide) inhibit Na+ absorption and hence there is more Na than before in lumen as compared to water. Hence loop diuretics and thiazides decrease positive free water clearance.
• Loops decrease Na+/Cl- absorption in thick ascending limb and thus there is a decrease in medullary hyperosmolarity. This decreases absorption of solute free water from the lumen of collecting duct in to the body. Hence loop diuretics decrease negative free water clearance as well.

Пікірлер: 83

@RanjanKumarPatel 4 жыл бұрын

75 hours of online pharmacology video for NEET/USMLE/FMGE/PLAB by Dr.Ranjan Kumar Patel at www.pharmle.com Integration is the current need of the hour and that is what PHARMLE gives you. PHARMLE integrates pharmacology with all preclinical as well and clinical subjects. Get your extra edge today by joining PHARMLE.

@doctorbhanuprakash 6 жыл бұрын

Best and awesome presentation and i dnt unerstand why ppl dislike video and looks like its a professional grudge or else i cant find any reason to dislike this one ....

@RanjanKumarPatel 6 жыл бұрын

Dr.G.Bhanu Prakash Thanks a lot dear for your kind words

@ApurvaPopat 4 жыл бұрын

Oh my goodness. This was super duper awesome. i didnt knew this concept in my entire MBBS. Thanska a lot

@dr_ksparejiya 2 жыл бұрын

Same 😂

@ahfaz6183 4 жыл бұрын

Jitna mushkil tha usse bhi zyada easy way me bataya aapne sir, thank you very much sir😊

@rinc2006 2 жыл бұрын

Crystal clear teaching, no time wasting.

@naaengmann2117 3 жыл бұрын

This was excellent! You will not regret watching this at all!!

@sailidnyanmothe5212 3 жыл бұрын

Best explanation out of all the difficult concepts I've ever studied. 🤯🤯 This emoji depicts my state after watching this lecture.

@viveknobody9006 3 жыл бұрын

Perfect sir,......esa best explain action kisi ne nahi diya...👍🏻👍🏻🙂

@Smnkar0 3 жыл бұрын

Never understood this concept before ...thank u sir

@thewise1788 2 жыл бұрын

Oh my god. That was the perfect explaination. Thank you very much sir.

@005adityaanurag2 2 жыл бұрын

Sir why we can not say negative free water clearance occurs for the water which is reabsorbed from thin descending loop of Henle ?

@ramkrishnashrestha5736 3 жыл бұрын

thank you so much sir...u explained in simple manner so that the concept of free water clearance is clear to me now...

@DrAlex18 Жыл бұрын

This is an awesome video, delivering the concept in a spectacular way . ❤️

@ubongekperikpe6647 3 жыл бұрын

Very simple to understand video. Thank you

@artisuthar9644 4 жыл бұрын

Thank u sir u have cleared all my doubts abouts diuretics

@pharmachemwithpooja7227 5 жыл бұрын

Your teaching is really good.all concept is clear.plz make video lecture on other pharmacological topic also.

@vijaychaitanya75 6 жыл бұрын

Awesome lecture sir 👌👌👌

@MukeshKumar-yl1vq Жыл бұрын

Thanks sir..... Koti koti pranam

@Alchemist064 2 жыл бұрын

Very well explained.Thank you so much sir..

@mayukhsarkar9556 2 жыл бұрын

It's a really awesome video sir. It made me easy to understand this topic..

@jayant112able 5 жыл бұрын

Thank u very much guruji.... Superb

@DrAnandRamanTiwari 6 жыл бұрын

Keep uploadin more Sir

@smitsheth6828 5 жыл бұрын

well explanation sir 👍👍👍

@saranya6199 4 жыл бұрын

Crystal clear sir. Thank you

@aadhaarsinghal8478 5 жыл бұрын

Amazing 👌

@adityapatil4293 3 жыл бұрын

I wasted 2 hr reading K.D tripathi and still did not got it .Sir explained the concept in just 5 min .thank you sir

@VivekSingh-ub8gr 4 жыл бұрын

Amazing!!!

@rashmisinha223 2 жыл бұрын

Thanku so much sir really clear my concept 🙏🙏🙏🙏

@AmoghavarshaNrupatunga 6 жыл бұрын

Beautiful explaination, crispy clarity :)

@RanjanKumarPatel 6 жыл бұрын

Girish Kiran Thanks dear

@medico465 Жыл бұрын

Thank you so much sir for clear this topic 😊

@anishamittal9665 3 жыл бұрын

Wow u make it so easy

@kartikeyasrivastava3719 2 жыл бұрын

great video. but the thin ascending limb is not permeable to water, it only has passive reabsorption of ions/solutes

@rezaayoubi9147 4 жыл бұрын

Thin ascending limb also absorbs NA cl

@SAURABHKUMAR-on4kb 4 жыл бұрын

Thank you so much sir... I get a clear concept of free water clearance and effects of diuretics on it... Thank you so much sir...

@RanjanKumarPatel 4 жыл бұрын

SAURABH KUMAR Welcome dear. God bless you 😊❤️

@doctorsimran9080 2 жыл бұрын

@@RanjanKumarPatel sir, I love your accent and your explanation really very pleasing.

@mickeysingh7443 4 жыл бұрын

Sir I cant get the feel of the basic formula of Free water clearance =volume of urine -osmotic clearance

@Pqr144 7 ай бұрын

Thank you so much sir

@yaser_medical 4 жыл бұрын

Woow , the best explanation about Free water clearance in KZfaq ♥️♥️

@OneTouchPharmacology 2 жыл бұрын

Thank you 👍🙏🏻

@OneTouchPharmacology 2 жыл бұрын

Thank you 👍🙏🏻

@OneTouchPharmacology 2 жыл бұрын

Thank you 👍🙏🏻

@keshavaggarwal2410 4 жыл бұрын

Thankyou sir you are best 😊😊👍

@gayathrisakthivel3511 4 жыл бұрын

I got lucky tday🤩 thanks sir... Rising from the ashes

@swathim6930 2 жыл бұрын

Thank u so much sir

@lakithamaratunga7423 3 жыл бұрын

Thank you Sir! ❤️

@shivamsoni7046 5 жыл бұрын

Thank you sir

@vijaymendhe1911 6 жыл бұрын

excellant sir..keep it up

@RanjanKumarPatel 6 жыл бұрын

vijay mendhe Thanks dear 😊

@zahramohammedhamedalmahroo1548 2 жыл бұрын

PERFECT

@abhijithrajagopal1142 5 жыл бұрын

Thank you so much sir😊

@Apratim98 2 жыл бұрын

Sir what will be the effect of CA inhibitor on negative free water clearance?

@062pavithrarani.a7 4 жыл бұрын

Thnk u soo much sir

@akarshswrld 5 ай бұрын

Positive free water clearance-water remaining in the lumen of thick ascending limb and DCT.. too much water reachinv collecting duct is reabsorbed causing negative free water clearance.. carbonic anhydrase inhibitor cause inhibition of sodium and water reabsorption, sodium drags water to TAL and gets reabsorbed ultimately causing increase in positive FWC.. loop diuretics by decreasing reabsorption of sodium decrease FWC. Thiazides also decrease FWC. Loop Diuretics decrease sodium in medulla causing decrease in medullary osmolarity and preventing water reabsorption, and thus decrease negative FWC so they decrease both positive and negative FWC Loop decrease both positive and negative FWC Thiazide decrease positive FWC CAI increase positive FWC

@naushadahmad9437 3 жыл бұрын

Sir available on play store ur app sir

@sourabhsaraswat1684 6 жыл бұрын

Thanku sir

@RanjanKumarPatel 6 жыл бұрын

Welcome dear Sourabh 😊👍🏻

@pramvirrathee1751 5 жыл бұрын

With respect, To be honest, This video is very complicated in the aspects of Physiology. Its a concept spoiler which is not good for USMLE. Its title should be Pharmacology aspect of Free water clearance. Free water clearance is - How much pure water is being excreted. if Urine Osm = 300msom/kg (270-290) Free water clearance is = 0, as no pure water is lost from Plasma. If Urine osmolarity >>300 mosm/kg, it means Urine had lost water, which is a negative Free water clearance - It Happens when Circulating ADH/AVP is Increased. If Urine Osm is

@RanjanKumarPatel 5 жыл бұрын

Pramvir Rathee Well i am a pharmacology teacher and my aim in this video was to make clear how drugs affect free water clearance. I hope you get the point, that this is not a physiology video.

@pramvirrathee1751 5 жыл бұрын

Ranjan Kumar Patel Yes Sir, Thats an awesome approach in pharmacological aspects.

@anurupmanna5955 4 жыл бұрын

In case of Negative water Clearence, When water is reabsorbing under the influence of ADH,how & why plasma Osmolarity increases? Please explain it

@surajpokharel4184 4 жыл бұрын

why thiazide no effect in negative free water clearance

@OneTouchPharmacology 3 жыл бұрын

Thiazide affects only the symports present in the distal convoluted tubules involved with absorption of solutes .. so it abolishes positive free water clearance. It has no action on the loops . Loops are responsible primarily for maintaining the corticomedullary gradient. This gradient drives water out of the thin descending limb and the collecting duct due to increased osmolarity... Thus thiazides have no action in negative free water clearance.

@arshithgowda8728 2 жыл бұрын

@@OneTouchPharmacology U got a subscriber

@thatssomedical1935 5 жыл бұрын

thank u

@HeetManvar 4 жыл бұрын

Sir then Why Carbonic Anhydrase inhibitors doesn't increase Negative free water clearance as after Loop urine will go to Collecting duct ?

@OneTouchPharmacology 3 жыл бұрын

Carbonic anhydrase inhibitors act in the proximal tubule. In this part of nephron there is iso osmotic absorption of water. So neither positive nor negative free water clearance.

@OneTouchPharmacology 3 жыл бұрын

Most of the solutes that reaches the loop and distal tubules are reabsorbed .. so there isn't an increase in negative free water clearance. Hope this clears your doubt

@bikashrajpaul260 4 жыл бұрын

What is its clinical significance?

@RanjanKumarPatel 4 жыл бұрын

Bikashraj Paul For diuretic effect we need solute to be present in the lumen. Drugs with negative free water clearance have more solute in lumen and are more effective diuretics.

@bikashrajpaul260 4 жыл бұрын

@@RanjanKumarPatel ok clear now😊

@apoorvsaxena8057 3 жыл бұрын

Sir if drugs with negative free water clearance are better diuretics then Thiazide diuretics should have more efficacy as compared to Loop diuretics ( beacause Loop diuretics decrease negative free water clearance ) but we know tht Loop diuretics have higher efficacy.

@hiteshvishwakarma6449 5 жыл бұрын

What is the significance of free water clearnace

@OneTouchPharmacology 3 жыл бұрын

When body is in water surplus state body removed excess water and if it is salt and water deprived..there is negative free water clearance. Primarily regulated by ADH