GMCH Chandigarh - 2019
Pharmacology
Easy
Furosemide acts on which part of the nephron?
Appeared in: GMCH Chandigarh - 2019
Explanation
- Furosemide is classified as a loop diuretic.
- Its primary site of action is the thick ascending limb of the loop of Henle.
- It works by inhibiting the Na-K-2Cl cotransporter (NKCC2), which is responsible for reabsorbing a significant portion of filtered sodium, potassium, and chloride.
- This inhibition leads to a powerful diuretic effect, as water follows the excreted ions.
- The disruption of ion transport in this segment also leads to increased urinary excretion of calcium and magnesium.
Why Other Options Were Wrong
- Option A: The proximal tubule is the primary site of action for carbonic anhydrase inhibitors (e.g., acetazolamide) and osmotic diuretics (e.g., mannitol), not loop diuretics like furosemide.
- Option B: The descending limb of the loop of Henle is highly permeable to water but has low permeability to solutes. Its main function is the passive reabsorption of water. Furosemide does not act here.
- Option D: The distal tubule is the primary site of action for thiazide diuretics (e.g., hydrochlorothiazide), which inhibit the Na-Cl cotransporter (NCC).
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacology: Mechanism and Site of Action of Diuretics as background academic context rather than a clinical decision trigger.
- Understanding the site of action of furosemide is critical for nurses to anticipate its effects and side effects. Its potent diuretic action requires close monitoring of fluid status (I&O, daily weight) and blood pressure to prevent dehydration and hypotension.
- Because furosemide increases potassium excretion, nurses must monitor for signs of hypokalemia (muscle weakness, cramps, arrhythmias) and check serum potassium levels as ordered.
- Patient education is a key nursing role. Instructing patients to take furosemide in the morning helps prevent nocturia and improves adherence and safety.
How to Approach the Question
- First, identify the drug mentioned in the question: Furosemide.
- Classify the drug. Recall or deduce that Furosemide is a 'loop diuretic'. The name itself provides a strong clue about its site of action.
- Relate the drug class to its location in the nephron. 'Loop diuretics' act on the 'loop of Henle'.
- Differentiate between the parts of the loop. Loop diuretics specifically target the thick ascending limb, where the Na-K-2Cl cotransporter is located.
- Evaluate the options based on this knowledge. The 'Ascending limb of the loop of Henle' is the correct site.
- Eliminate other options by recalling the sites of action for other diuretic classes (e.g., thiazides act on the distal tubule, carbonic anhydrase inhibitors on the proximal tubule).
Concept Tested & Keywords
- Concept Tested: Pharmacology: Mechanism and Site of Action of Diuretics
- Stem keywords: Furosemide, nephron, acts on
- Lead-in keywords: which part
Question ID
QHkXeQUZ5duSwf883IIB3z
Reference Book
E6 Pharmacology KD Tripathi Essentials 9e Part 2 p. 252-254
E6 Pharmacology Katzung 16e p. 392-394
E6 Medicine Harrison 22e Part 2 p. 273-275
Practise the full GMCH Chandigarh - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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