Diuretics by srota dawn

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Diuretics by srota dawn

  1. 1. DIURETICS by SROTA DAWN. B.PHARM(3RD YEAR)
  2. 2. Definition: A diuretic can be defined as a chemical that increases the rate of urine formation. The PRIMARY ACTION: Direct inhibition of Na+ transport along one or more of the four major anatomical sites.
  3. 3. 4 major sites of nephron: SITE 1 : The “PCT” SITE 2 : The thick ascending limb of “HENLE’s LOOP” SITE 3 : The “DCT” SITE4:The“collecting tubule & cortical collecting Tubule”
  4. 4. SITE OF ACTION TYPE OF DIURETICS EXAMPLES 1. SITE  DIURETICS Carbonic anhydrase inhibitors Acetazolamide , methazolamide , dichlorphenamide etc. 2. SITE  DIURETICS Loop diuretics organomercurals,furos emide,bumetanide,azo semideetc 3. SITE  DIURETICS Thiazide & thiazide like diuretics Chlorthiazide, benzthiazide, hydrochlorthiazide etc. 4. SITE  DIURETICS Potassium-sparing diuretics Spironolactones Triamterene,amiloride 5.OTHERS Osmotic diuretics Mannitol, Isosorbide, glycerol
  5. 5. SITE 1 DIURETICS: CARBONIC ANHYDRASE INHIBITORS MOA:INHIBITION OF CAase 1. intracellularly 2. In luminal brush border effects: reabsorption of Na+,HNO3- Seondary effect:  excretion of K+ USE: 1.Glaucoma 2.Promote exeretion of weakly acidic drug 3. In epilepsy 4. Acute mountain sickness ADR: 1. metabolic acidosis 2.hypokalemia 3.20%  in GFR 4.sulphonamide associat ed hypersensitivity reactions.
  6. 6. SITE 2 DIURETICS: HIGH- CEILING Or LOOP DIURETICS MOA: 1.Inhibit the 1Na+/1K+/2Cl- cotransport system EFFECTS: Reabsorption of Na+, K+,C l- Use: 1.edemacardiac,hepatic,renal 2.Acute pulmonary edema associated with CHF 3.HYPERCALCAEMIA & Renal calcium stones ADR: 1.Sulfnamoyl moiety associated hypersensitivity reactions 2.Hypokalemia intensifies the Toxicity of cardiac glycosidesSITE 2: Henle's loop
  7. 7. SITE 3 DIURETICS: THIAZIDE DIURETICS MOA: All of these diuretics block the Na+ reabsorption by inhibiting The LUMINAL MEMBRANE bound Na+/Cl- cotransport system Effects: Naturetic,chloruretic,saluretic, kaluretic& weak bicarbonaturetic Use: 1.edema associated CHF 2.hypertension(uncomplicated) ADR: 1.Hypersensitivity reaction 2.Hypokalemia 3.cardiac output
  8. 8. SITE 4 : COLLECTING TUBULE& CORTICAL COLLECTING TUBULE SITE 4 DIURETICS: POTASSIUM SPARING DIURETICS MOA: SPIROLACTONEs: inhibit reabsorption of Na+ by compititively inhibiting the actions of ALDOSTERONE OTHERS: Plug the Na+ channels of Luminal membrane EFFECTS: Na+,Cl- exeretion without Concomitant increase in urinary excretion rate of K+ USE: 1.Combination therapy with site 2&3 diuretics 2.Mild edema associated CHF 3.HYPERTENSION
  9. 9. OTHERS: MANNITOL: High luminal fluid concentration of mannitol create an osmotic effect .this effect prevents the reabsorption of Water. Use: Used in hospital setting to keep the nephrons open. Decrease CSF volume & pressure.
  10. 10. THANK YOU

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