Diuretics

1. Diuretics
It is Drugs that accelerate the rate of urine formation
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Types of Diuretics
Acetazolamide
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Loop diuretics
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Mannitol
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Potassium-sparing diuretics
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Thiazide and thiazide-like diuretics
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1) Acetazolamide
Block the action of carbonic anhydrase
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Resorption of water is decreased
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urine volume is increased.
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indications; It is also useful in the treatment of glaucoma, edema and epilepsy, Severe metabolic alkalosis,
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High altitude sickness
2) Loop Diuretics
Common ones: bumetanide (Bumex), furosemide (Lasix), torsemide (Demedex)
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Increase renal prostaglandins, resulting in the dilation of blood vessels and reduced peripheral vascular
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resistance.
Inhibit N-K-2Cl pump in TAL
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Promote high volume diuresis by decreasing solute reabsorption and blunting medullary osmotic gradient
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Indications; Edema associated with HF, Hypertension, hypercalcemia, cirrhosis, pulmonary edema.
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Adverse Effects; Dizziness Agranulocytosis, Hyperglycemia, headache Neutropenia.
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3) Mannitol (Osmitrol)
Osmotic Diuretics
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Work mostly in the proximal tubule
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Nonabsorbable, producing an osmotic effect
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Freely filtered by glomerulus, no reabsorption
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More water excretion by osmosis
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Drug Effects; Increases glomerular filtration and renal plasma flow.
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Indications; Reduction of intracranial pressure, Treatment of cerebral edema, glaucoma.
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Adverse Effects; pulmonary edema, Thromophlebitis, Headaches, Chest pains
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Caution with renal disease: less excretion, buildup and expansion of intravascular volume.
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4) Thiazide and thiazide-like diuretics
Common ones; HCTZ, chlorothiazide, trichloromethiazide, metolazone.
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Inhibit tubular resoption of sodium, chloride, and potassium ions
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Result: Water, sodium, and chloride are excreted
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Potassium is also excreted to a lesser extent
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Dilate the arterioles by direct relaxation
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Contain sulfur -allergies
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Can cause hyperglycemia, hyperlipidemia, hyperuricemia,
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Drug effects; Lowered peripheral vascular resistance and Depletion of sodium and water (and potassium)
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Indications; Hypertension, Edematous states, Idiopathic hypercalciuria, Diabetes insipidus
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Adverse Effects; Dizziness Impotence, Headaches Urticaria, Anorexia hyperglycemia, hypokalemia
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2. 5) Potassium-sparing diuretics
Common ones; Spironolactone, eplerenone
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Also Known, Aldosterone-inhibiting diuretics
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Aldosterone antagonists
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Interfere with sodium-potassium exchange
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Competitvely bind to aldosterone receptors
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Block the resorption of sodium and water usually induced by aldosterone
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(Aldosterone is a hormone that increases the reabsorption of sodium and water and the release of potassium in
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the kidneys)
Drug Effects; Prevent potassium from being pumped into the tubule and The excretion of sodium and
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water is promoted.
Indications; hyperaldosteronism, hypertension
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Adverse Effects; Dizziness, Headaches Gynecomastia, hyperkalemia
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