Diuretics work by interfering with electrolyte reabsorption in the kidney to promote excretion of sodium and water. They are classified based on where in the nephron they act: carbonic anhydrase inhibitors act in the proximal convoluted tubule; loop diuretics act on the ascending loop of Henle; thiazide diuretics act in the distal convoluted tubule; and aldosterone inhibitors act on the collecting tubule. Common diuretics include acetazolamide, furosemide, hydrochlorothiazide, and spironolactone. They are used to treat conditions like hypertension, heart failure, and edema. Adverse effects can include electrolyte imbalances like hyp
Diuretics | Definition | Mechanism of Action | Classes of DrugsChetan Prakash
This presentation provides knowledge about Diuretics,Role of sodium, types of urine output, General mechanism of action, Normal Physiolofy of urine formation, GFR Formation, Classes of Diuretics, diuretics abuse and recent discovery. An assignment for the subject, Advanced Pharmacology-I, 1st year M.Pharm, 1st semester.
Diuretics
Pharmacology
Katzung
Abnormalities in fluid volume and electrolyte composition are common and important clinical disorders. Drugs that block specific transport functions of the renal tubules are valuable clinical tools in the treatment of these disorders. Although various agents that increase urine volume (diuretics) have been described since antiquity, it was not until 1937 that carbonic anhydrase inhibitors were first described and not until 1957 that a much more useful and powerful diuretic agent (chlorothiazide) became available. Technically, a “diuretic” is an agent that increases urine volume, whereas a “natriuretic” causes an increase in renal sodium excretion and an “aquaretic” increases excretion of solute-free water. Because natriuretics almost always also increase water excretion, they are usually called diuretics. Osmotic diuretics and antidiuretic hormone antagonists (see Agents That Alter Water Excretion) are aquaretics that are not directly natriuretic.
Diuretics | Definition | Mechanism of Action | Classes of DrugsChetan Prakash
This presentation provides knowledge about Diuretics,Role of sodium, types of urine output, General mechanism of action, Normal Physiolofy of urine formation, GFR Formation, Classes of Diuretics, diuretics abuse and recent discovery. An assignment for the subject, Advanced Pharmacology-I, 1st year M.Pharm, 1st semester.
Diuretics
Pharmacology
Katzung
Abnormalities in fluid volume and electrolyte composition are common and important clinical disorders. Drugs that block specific transport functions of the renal tubules are valuable clinical tools in the treatment of these disorders. Although various agents that increase urine volume (diuretics) have been described since antiquity, it was not until 1937 that carbonic anhydrase inhibitors were first described and not until 1957 that a much more useful and powerful diuretic agent (chlorothiazide) became available. Technically, a “diuretic” is an agent that increases urine volume, whereas a “natriuretic” causes an increase in renal sodium excretion and an “aquaretic” increases excretion of solute-free water. Because natriuretics almost always also increase water excretion, they are usually called diuretics. Osmotic diuretics and antidiuretic hormone antagonists (see Agents That Alter Water Excretion) are aquaretics that are not directly natriuretic.
These drugs include a heterogeneous class of compounds which act by preventing the entry of slow calcium ions into the cellos which are required for the contraction of muscles. These drugs act on the calcium channel receptors and cause blockade of the calcium channels.
ACE inhibitors block the angiotensin-converting enzyme found throughout vascular tissue that converts angiotensin I to angiotensin II. Let us know how do ACE Inhibitors work?
in this presentation i have tried to briefly discuss about diuretics (water pills), their classification, mechanism of action, pharmacokinetics and pharmacodynamics of these drugs
These drugs include a heterogeneous class of compounds which act by preventing the entry of slow calcium ions into the cellos which are required for the contraction of muscles. These drugs act on the calcium channel receptors and cause blockade of the calcium channels.
ACE inhibitors block the angiotensin-converting enzyme found throughout vascular tissue that converts angiotensin I to angiotensin II. Let us know how do ACE Inhibitors work?
in this presentation i have tried to briefly discuss about diuretics (water pills), their classification, mechanism of action, pharmacokinetics and pharmacodynamics of these drugs
Pharmacology of drugs acting on Renal System.pdfAFFIFA HUSSAIN
Diuretics also known as water pills increases the excretion of water and electrolytes (Na+) in
urine.
Natriuresis – large amount of sodium excreted in urine due to the action of kidneys.
Promoted by – ventricular and atrial natriuretic as well as calcitonin.
Inhibited by chemicals such as aldosterone. The drugs which increases sodium excretion are
known as natriuretic.
Diuresis – increased or excessive production of urine. The drugs which enhances the excretion
of water without loss of electrolyte is called as aquaretic.
Diuretics are medicines that help reduce fluid buildup in the body. They are sometimes called water pills. Most diuretics help the kidneys remove salt and water through the urine. This lowers the amount of fluid flowing through the veins and arteries. As a result, blood pressure goes down.
Diuretics are drugs that increase the flow of urine. They are commonly used to treat edema, hypertension, and heart failure. Typically, the pharmacological group consists of five classes: thiazide diuretics, loop diuretics, potassium-sparing diuretics, osmotic diuretics, and carbonic anhydrase inhibitors.
There are three main types of diuretic: loop diuretics, thiazide diuretics and potassium-sparing diuretics.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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2. DIURETICS
DEFENITION
Diuretic is a drug , which increase the urine output of electrolyte and water from the kidney by
interfering with one (or) more reabsoprtive process occurring at different segment of nephrone which promote
excrete of sodium and water from body by an action of kidney.
CLASSIFICATION
1.During acting proximal convoluted tubule “Carbonic Anhydrase Inhibitors”
Acetazolamide, Dichlorphenamide,Methazolamide
2,3.During acting on ascending Loop of Henle “Loop diurectic”
Furosemide,Bumetanide,Torsemide,Piretanide and Etha-Cryni-C Acid, Indacrinone(uricosuric diurectic).
4.During acting Distal Convoluted tubule “Thiazide diurectic”.
Thrazide , Chlorthiazide , Benzthiazide , Hydrochlorthiazide.
5. During acting on collecting tubule and dust “Aldosterone Inhibitor”
Spiranolactone,Explerenone.
6. During acting Indiretly and modifying the content of urinary filtration “Osmotic Diurectic”
Mannitol , Potassium acetate, Glycerol.
3.
4.
5. Carbonic anhydrase Inhibitor:
Acetazolamide is the most common drug that inhibit the enzyme carbonic anhydrase in proximal
tubule.
Acetazolamide:
Mechanism of action: Acetazolamide inhibit carbonic anhydrase located in cytoplasm and atypical
membrane of Proximal tubule .Carbonic anhydrase catalyses the reaction of CO2 and H2O leading to H2CO3
which spontaneously ionise hydrogen and HCO3 the decrease ability to exchange sodium and hydrogen .In
presence of acetazolamide result mild diuretics .Additional HCO3 retain un lumen with marked elevation in
urinary ph lose of HCO3 causes hyperchloremic Metabolic acidosis.
6. Therapeutic uses:
Treatment of glaucoma,diuretics,acute mountain sickness,epilepsy.
ADME:
Acetazolamide given orally once four times daily.It secreated by proximal tubule.
Adverse reaction:
Metabolic acidosis,potassium depletion,renal stone formation,drowsiness.
7. Loop Diuertics
They act on ascending loop of Henle.Compare to other class of drugs this have highest efficacy in
mobilizing sodium and potassium from the body.
Eg:Furosemide,etharynic acid.
Furosemide:
It is a rapid acting diuretics.It increases upto 10L of urine may be produced in a day . It inhibit Na+/K-
/2Cl cotransporter.
Mechanism of action:
loop diuretis inhibit cotransport of Na+/K+/2Cl- .In luminal membrane ,in asending loop of
henle,therefore reabsorption of these ion decresed,this is most efficacious diuretic drug because the
ascending limb accounts for reabsorption of 25 to 30% of filtered Nacl.
Loop diuretic act promply in patients have poor renal function and those who not respond to
thiazide.Loop diuretics carises decreases renal vascular resistance and increases blood flow.
Therapeutics uses:
Reducing acute pulmonary edema,heart failure,treating hyper calcemia because it stimulate calcium
excreation,treatment of hyper kalemia.
8. ADME:
Loop diuretics administer oraly they secreted through urine.Duration of action 2-4hrs.
Adverse effect:
Ototoxicity,hyper uricemia,potassium depletion,hypomagnesemia.
9. Thiazide diuretics:
This are most widely used diuretics.They are sulphonamide diuretic.
Eg:Thiazide,chlorthiazide.
Thiazide
They act in distal tubule.
Mechanism of action:
Thiazide derivatives act in distal tubule to decreases reabsorption of Na+ by inhibiting Na+/cl-
cotransporter on luminal membrane of distal convoluted tubule result the increase concentration of Na+
and cl- tubular fluid,the acid-base balance not usually affected.
10. ADME
Drug affective oraly,most thiazide take 1 to 3 weeks to produce stable reduction in BP.
Pharmacological action:
a)Increased excretion of Na+ and cl-.In causes increase Na+ and cl- excretion .Which result excretion of
hyper osmolar urine.
b)Loss of K+:Because thiazide increase the Na+ in the filtrate arriving at the distal tubular more K+ is
also exchange for Na+ resulting in continual loss of K+ from the body with prolonged use of these drug.
c)Loss of Mg2+:Magnesium deficiency requiring supplementation.
d)Decrease urinary calcium excretion:Thiazide diuretic decrease Ca2+ content of urine by promoting
reabsorption of Ca2+.
e)Reduced peripheral vascular resistance:Initial reduction in BP result decrease blood volume and
decrease CO.
Therapeutic uses:
Hypertension,heart failure,hyper calciuria,diabetes insipidus.
Adverse effect:
Potassium depletion,hyponatremia,hyper uricemia,hyper calcemia,hyper glycemia.
11. Aldosterone inhibitor(potassium sparing diuretics)
Potassium sparing diuretics act in collecting tubule to inhibit Na+ reabsorption and K+ excretion.
Eg:spironolactone.
Spironolatone
Mechanism of action:
Spironolactone is synthetic steroid that antagonize aldosterone,Intracellular cytoplasm receptor.
It become inactive and prevent translocation of receptor complex in to nucleus of target cell.This result
failure to produce proteins normally synthesised in response to aldosterone. This mediator protein stimulate
Na+/K+ exchange site of collecting tubule and prevent Na+ reabsorption K+ and H+ secretion.
Pharmacological action:
This drug may less endocrine effect.
Therapeutic uses:
Diuertic,secondary hyperaldosteronium,heart failure.
13. Osmotic diuretics
Manitol
It is non electrolyte of low molecular weight.Large quantity required to raise osmolarity of plasma
and tubular fluid.It is not metabolised in body freely filtered in glomerules.
Administration:
Manitol is not absorbed orally has to given IV as 10-20% solution.It excreated with a t1/2 of 0.5-1.5hrs.
Therapeutic uses:
Treatment of congestive glaucoma,it is used in patient with renal failure,pulmonary edema,heart
failure.