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Diuretics by srota dawn
Diuretics by srota dawn
Diuretics by srota dawn
Diuretics by srota dawn
Diuretics by srota dawn
Diuretics by srota dawn
Diuretics by srota dawn
Diuretics by srota dawn
Diuretics by srota dawn
Diuretics by srota dawn
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Diuretics by srota dawn

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  • 1. DIURETICS by SROTA DAWN. B.PHARM(3RD YEAR)
  • 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. 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. 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. 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. 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. 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. 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. 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. THANK YOU

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