Loop diuretics act on the thick ascending loop of Henle by blocking the Na-K-2Cl symporter. They are used to treat conditions like acute cardiac failure, pulmonary edema, peripheral edema, hypertension, and hypercalcemia. Common side effects include hypokalemia, hypomagnesemia, and hypocalcemia. They can interact with aminoglycosides to cause ototoxicity and nephrotoxicity. Examples include furosemide, torsemide, and bumetanide. Furosemide is most commonly used and causes venodilation as well as increased renal blood flow through prostaglandin synthesis.

1. LOOP DIURETICS
OR
HIGH CEILING DIURETICS

2. Site-1 Site-3
Site-2
Site-4

3. ASCENDING LOOP OF HENLE
CELL IN MEDULLARY PORTION
Na+
K+
2Na+
B
L
O
O
D
Cl-
K+
Mg
+
Ca+
LUMEN
Na
Cl
K
Cl-
3K+

4. c
Na
K
2Cl
Ca,Mg
Na
K
2Cl
K
Cl
Luminal side Blood vessel

5. CLINICAL USES
• Acute cardiac failure
• Pulmonary edema : Congestive cardiac failure
• Peripheral edema : nephrotic syndrome , ascitis
• Hypertension
• Hypercalcemia
• Forced diuresis : HYPER
Cl-
Br -
I-

6. ADVERSE EFFECTS
• HypO - kalemia
natremia
calcemia
magnesemia
volemia
• OTOtoxicity
• Hyperuricemia
• Hyerglycemia

7. DRUG INTERACTIONS
• Aminoglycosides : Ototoxicity
Nephrotoxicity
• Serum LITHIUM
• Hypokalemia casues – Cardiac arrythmia , digitalis toxicity,muscle
cramps,weakness.
NOT TO BE GIVEN TOGETHER
NSAIDS
PROBENECID

8. EXAMPLES
• ETHACRYNIC ACID
• TORSEMIDE
• BUMETANIDE
• FUROSEMIDE
EAt That Fab Biryani

9. FUROSEMIDE
1.Taken PO or I.V
2.Most commonly used.
3.Most efficient diuretic.
4. Causes venodilation
as well
5.PGs synthesis is also
seen which increases
the RBF
DOSE-PO-40mg
Inj.20mg/2ml
TORSEMIDE
1.Taken orally.
2.Better availability
3.Better absorbtion.
4.Fast onset of action
DOSE-1-5mgPO
Inj-2-4mg iv/im
BUMETANIDE
1.Taken orally
2.40 times more
potent than
furosemide
3. Fast onset of action
4.Short duration action
DOSE-2.5-5mg OD
5-20mg/day in edema
.
Contain sulfa group

10. LOOP DIURETICS
• Acts on Thick Ascending loop of Henle.
• Blocks Na-K-2Cl symporter.
1. FUROSEMIDE most commonly used.
2. Torsemide and Bumetanide taken orally.
3. Most efficient group of diuretics.