Diuretics are chemicals that increase urine formation by increasing sodium and chloride ion excretion. There are several classes of diuretics that act at different sites along the nephron. Loop diuretics act in the ascending loop of Henle by inhibiting sodium-potassium-chloride transport. Thiazides act in the distal convoluted tubule by inhibiting sodium and chloride transport. Carbonic anhydrase inhibitors act in the proximal tubule by inhibiting the enzyme carbonic anhydrase. Potassium-sparing diuretics act in the collecting duct and do not promote potassium secretion. Osmotic diuretics act by increasing osmotic pressure in the proximal tubule and loop of Henle to prevent water

1. DIURETICSSeminar report submitted in partial fulfilment for the award of degree of
B.Pharm (6th sem,3rd year)
By
MR. SAMARJIT BOSE
REGD NO: 131740210042
ROLL NO: 17401913054
NETAJI SUBHAS CHANDRA CHANDRA BOSE INSTITUTE OF PHARMACY
(AFFILIATED BY MAKUT)

2. DEFINITION :-
 Diuretics are chemicals that increase the rate of
urine formation. By increasing the urine flow rate
in kidney, diuretic usage leads to the increased
excretion of electrolytes (especially sodium
and chloride ion) and water from the body.
 Example of diuretics are caffeine,
yerba mate, nettles, cranberry juice, alcohol.

3. PHARMACOLOGICAL CLASSIFICATION
A. Loop diuretics
B. Thiazides
C. Carbonic anhydrase inhibitor
D. Potassium sparing diuretics
1. Aldosterone antagonists
2. Epithelial sodium channel blocker
E. Osmotic diuretics

4. SUMMARY: SITES OF ACTION

5. Loop diuretics (Inhibitors of Na+-K+-2Cl- co-transport):-
 Mechanism of action:
 Loop diuretics inhibit the body's ability to reabsorb sodium at the
ascending loop in the kidney which leads to a retention of water
in the urine.
 No transport systems in descending loop of henle.
 Inhibits Na-K-2Cl transporter in thick ascending loop of henle.
 Competes with Cl- binding site
 Use : a. edema: cardiac, pulmonary or renal
b. hypertension
 Example of loop diuretics include Furosemide,Bumetanide,Ethacrynic acid and Torsemide

6. B. Thiazides:-
 Mechanism of action :
 active in distal convoluted tubule.
 inhibit Na+ and Cl- transporter in
distal convoluted tubules.
 increased Na+ and Cl- excretion.
 weak inhibitors of carbonic anhydrase.
 Use : a. hypertension
b. congestive heart failure
 Example of thiazides include Cholorthalidone, Hydroclorothiazide, Metolazone

7. C. Carbonic anhydrase inhibitor:-
 Mechanism of action :
 Inhibits carbonic anhydrase in renal proximal tubule cells.
 Carbonic anhydrase catalyzes formation of HCO3- and H+
from H2O and CO2.This formation is inhibited by
CA inhibitors.
 Suppress CO2 reabsorption from glomerular filtrate.
 Na+ - HCO3
- excretion is increased.
 Use : a. CA inhibitors reduce intraocular pressure
in glaucoma by decreasing production
of aqueous humor.
b. acute mountain sickness.
 Example of carbonic anhydrase inhibitor include Acetazolamide

8. D. Potassium sparing diuretics :-
 Mechanism of action :
 K+ sparing diuretics function in CCD
 Do not promote the secretion of potassium
into the urine.
 decrease Na+ transport in collecting tubule.
 Aldosterone antagonists
 Epithelial sodium channel blockers
 Use : a. primary hyperaldosteronism
b. cirrhosis
 Example of potassium sparing diuretics include Spironolactone , Triamterene,
Amiloride.

9. E. . Osmotic diuretics :-
 Mechanism of action :
 osmotic diuretics are not reabsorbed.
 increases osmotic pressure specifically in the
proximal tubule and loop of Henle.
 prevents passive reabsorption of H2O.
 increased Na+ excretion.
 Use : a. drug of choice: non-toxic, freely filtered,
non-reabsorbable .
b. administered prophylactically for CVS disease,
surgery.
 Example of osmotic diuretics include Manitol, Urea,
Glycerol.

10. THERAPEUTIC USES
 In medicine, diuretics are used to treat chronic heart
failure.
 Liver cirrhosis
 Hypertension
 Water poisoning
 Certain kidney diseases.
 Pregnancy associated edema.
 Nephrotic syndrome.

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