This document summarizes different types of diuretic drugs, including their mechanisms of action, indications for use, and potential adverse effects. It discusses 5 main classes of diuretics: 1) acetazolamide, which blocks carbonic anhydrase and decreases water resorption, 2) loop diuretics like furosemide that inhibit the NKCC2 pump and promote high volume diuresis, 3) mannitol, an osmotic diuretic that works in the proximal tubule, 4) thiazide and thiazide-like diuretics that inhibit sodium resorption in the distal tubule, and 5) potassium-sparing diuretics like spironolactone

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

2. 5) Potassium-sparing diuretics
Common ones; Spironolactone, eplerenone
•
Also Known, Aldosterone-inhibiting diuretics
•
Aldosterone antagonists
•
Interfere with sodium-potassium exchange
•
Competitvely bind to aldosterone receptors
•
Block the resorption of sodium and water usually induced by aldosterone
•
(Aldosterone is a hormone that increases the reabsorption of sodium and water and the release of potassium in
•
the kidneys)
Drug Effects; Prevent potassium from being pumped into the tubule and The excretion of sodium and
•
water is promoted.
Indications; hyperaldosteronism, hypertension
•
Adverse Effects; Dizziness, Headaches Gynecomastia, hyperkalemia
•