Mrs. VARSHA JAIN BA provides information on diuretics, including:
1. Diuretics work by interfering with transport mechanisms in the nephron to increase urine output and salt and water loss. The main classes are loop diuretics, thiazide diuretics, potassium-sparing diuretics, and osmotic diuretics.
2. Loop diuretics like furosemide act on the thick ascending limb of the loop of Henle. Thiazides like hydrochlorothiazide act in the distal convoluted tubule.
3. Potassium-sparing diuretics include aldosterone antagonists like spironolactone and epithelial
The document discusses various classes of diuretics including loop diuretics, thiazide diuretics, potassium sparing diuretics, carbonic anhydrase inhibitors, and osmotic diuretics. It focuses on the mechanisms of action, indications, and side effects of specific drugs within each class. It provides details on the pharmacology of spironolactone, amiloride, triamterene, acetazolamide, and mannitol. Clinical uses and precautions for different diuretics in conditions like edema, hypertension, heart failure, and kidney stones are also reviewed.
Diuretics : Dr Renuka Joshi MD,DNB, (FNB )Renuka Buche
This document discusses different classes of diuretic drugs, including their mechanisms of action, examples, effects, dosages, and interactions. It covers loop diuretics like furosemide and bumetanide that act in the thick ascending loop of Henle; thiazide diuretics like hydrochlorothiazide that act in the distal convoluted tubule; and potassium-sparing diuretics like spironolactone and amiloride that act in the collecting duct. It provides recommendations for diuretic use and combinations in the treatment of heart failure and fluid overload.
Drugs used for enhance excretion ( Diuretics)Adarsh SA
Diuretics enhances the urine output. It is mainly used in treatment of hypertension, hypervolumia, edema, congestive cardiac failure, electrolyte imbalances etc. They have some adverse reactions like hypotension, dehydration, hypovolumia, etc.
The document summarizes different classes of diuretic drugs, including their mechanisms of action, pharmacokinetics, uses, and side effects. It discusses loop diuretics like furosemide that act in the loop of Henle, thiazide diuretics like hydrochlorothiazide that act in the distal tubule, potassium-sparing diuretics like spironolactone that antagonize aldosterone, and osmotic diuretics like mannitol that cause water diuresis through osmosis. Loop and thiazide diuretics can cause hypokalemia and metabolic alterations while potassium-sparing diuretics risk hyperkalemia if not carefully monitored. Di
Thiazide diuretics such as hydrochlorothiazide, chlorothiazide, and metolazone act in the distal convoluted tubule by inhibiting the sodium-chloride co-transporter, leading to increased sodium excretion. They are used to treat hypertension, heart failure, and calcium kidney stones. Side effects include hypokalemia, hyperuricemia, and fluid and electrolyte imbalances. Potassium-sparing diuretics such as spironolactone work in the collecting tubules by blocking aldosterone receptors or sodium channels, reducing sodium reabsorption and potassium loss. They are used for conditions like cirrhosis and treat hypertension. Risks include hyperkalemia
Diuretic agents work by increasing urine output and sodium excretion. There are several classes of diuretics including carbonic anhydrase inhibitors, loop diuretics, osmotic diuretics, potassium-sparing diuretics, and thiazide diuretics. Nursing care involves monitoring for therapeutic and adverse effects such as hypokalemia, hypotension, and fluid imbalance.
The document discusses various classes of diuretics including loop diuretics, thiazide diuretics, potassium sparing diuretics, carbonic anhydrase inhibitors, and osmotic diuretics. It focuses on the mechanisms of action, indications, and side effects of specific drugs within each class. It provides details on the pharmacology of spironolactone, amiloride, triamterene, acetazolamide, and mannitol. Clinical uses and precautions for different diuretics in conditions like edema, hypertension, heart failure, and kidney stones are also reviewed.
Diuretics : Dr Renuka Joshi MD,DNB, (FNB )Renuka Buche
This document discusses different classes of diuretic drugs, including their mechanisms of action, examples, effects, dosages, and interactions. It covers loop diuretics like furosemide and bumetanide that act in the thick ascending loop of Henle; thiazide diuretics like hydrochlorothiazide that act in the distal convoluted tubule; and potassium-sparing diuretics like spironolactone and amiloride that act in the collecting duct. It provides recommendations for diuretic use and combinations in the treatment of heart failure and fluid overload.
Drugs used for enhance excretion ( Diuretics)Adarsh SA
Diuretics enhances the urine output. It is mainly used in treatment of hypertension, hypervolumia, edema, congestive cardiac failure, electrolyte imbalances etc. They have some adverse reactions like hypotension, dehydration, hypovolumia, etc.
The document summarizes different classes of diuretic drugs, including their mechanisms of action, pharmacokinetics, uses, and side effects. It discusses loop diuretics like furosemide that act in the loop of Henle, thiazide diuretics like hydrochlorothiazide that act in the distal tubule, potassium-sparing diuretics like spironolactone that antagonize aldosterone, and osmotic diuretics like mannitol that cause water diuresis through osmosis. Loop and thiazide diuretics can cause hypokalemia and metabolic alterations while potassium-sparing diuretics risk hyperkalemia if not carefully monitored. Di
Thiazide diuretics such as hydrochlorothiazide, chlorothiazide, and metolazone act in the distal convoluted tubule by inhibiting the sodium-chloride co-transporter, leading to increased sodium excretion. They are used to treat hypertension, heart failure, and calcium kidney stones. Side effects include hypokalemia, hyperuricemia, and fluid and electrolyte imbalances. Potassium-sparing diuretics such as spironolactone work in the collecting tubules by blocking aldosterone receptors or sodium channels, reducing sodium reabsorption and potassium loss. They are used for conditions like cirrhosis and treat hypertension. Risks include hyperkalemia
Diuretic agents work by increasing urine output and sodium excretion. There are several classes of diuretics including carbonic anhydrase inhibitors, loop diuretics, osmotic diuretics, potassium-sparing diuretics, and thiazide diuretics. Nursing care involves monitoring for therapeutic and adverse effects such as hypokalemia, hypotension, and fluid imbalance.
Diuretic agents work by increasing urine output and sodium excretion. There are several classes of diuretics including carbonic anhydrase inhibitors, loop diuretics, osmotic diuretics, potassium-sparing diuretics, and thiazide diuretics. Nursing care involves monitoring for therapeutic and adverse effects such as hypokalemia, hypotension, and fluid imbalance.
Drugs used in gastrointestinal system for PCLsarosem
This document discusses drugs used in the gastrointestinal system including antiemetics, antidiarrheals, laxatives, and drugs that reduce gastric acid. It provides details on common drugs in each category such as metoclopramide and ondansetron for antiemetics, loperamide for antidiarrheals, and proton pump inhibitors like omeprazole for gastric acid reduction. Nursing considerations are also outlined for the administration and monitoring of these gastrointestinal drugs.
This document discusses different classes of diuretic drugs, including their sites of action in the nephron, mechanisms of action, therapeutic uses, and side effects. It covers osmotic diuretics, carbonic anhydrase inhibitors, thiazide diuretics, loop diuretics, and potassium-sparing diuretics. The main points are that diuretics work by inhibiting transport in different parts of the nephron like the proximal tubule, loop of Henle, or distal convoluted tubule. They are used to treat conditions like edema, hypertension, and heart failure. Common side effects among the classes include electrolyte imbalances and metabolic alterations.
This document summarizes antidiarrheal and laxative drugs, including their mechanisms of action, uses, side effects, and nursing considerations. It describes different types of antidiarrheal drugs like adsorbents, anticholinergics, and opiates that work by coating the GI tract, decreasing intestinal motility, or decreasing bowel transit time. It also outlines various laxative categories including bulk-forming, emollient, hyperosmotic, saline, and stimulant laxatives and how they work to treat constipation. Nursing priorities are discussed like assessing for electrolyte imbalances, encouraging diet and fluid changes over long-term laxative use, and monitoring for therapeutic effects and side effects
Diuretics work by inhibiting reabsorption of sodium and water in the kidneys, increasing urine output. There are several types of diuretics that act in different parts of the kidney: loop diuretics act in the ascending limb of Henle's loop, thiazide diuretics act in the distal convoluted tubule, and potassium-sparing diuretics act in the cortical collecting tubule. Diuretics are used to treat conditions like heart failure, liver failure, renal failure, and hypertension by mobilizing edema fluid and maintaining urine volume. Common side effects include hypokalemia, hyperglycemia, and increased uric acid levels.
The document discusses diuretics, which are drugs that increase urine production. It defines diuretics and describes their primary mechanism of action as inhibiting sodium reabsorption along the nephron. This leads to increased sodium and water excretion, reducing extracellular fluid volume and edema. The document classifies major types of diuretics, including carbonic anhydrase inhibitors, loop diuretics, thiazides, and potassium-sparing diuretics. It provides examples of drugs for each class, along with their uses, mechanisms, and side effects. Structure-activity relationships that determine diuretic activity are also summarized.
This document discusses different types of diuretic drugs, how they work, and their uses. It covers high-ceiling loop diuretics which inhibit sodium reabsorption; thiazide diuretics which inhibit sodium transport in the distal convoluted tubule; carbonic anhydrase inhibitors which reduce hydrogen ion secretion; potassium-sparing diuretics which act in the cortical collecting duct; and osmotic diuretics like mannitol. Diuretics are used to treat conditions causing fluid retention like heart failure and liver disease. Side effects include electrolyte abnormalities and dehydration. Loop diuretics are commonly used for heart failure but may require intravenous administration for severe cases.
This document discusses various classes of diuretic drugs including loop diuretics, thiazide diuretics, thiazide-like diuretics, potassium-sparing diuretics, carbonic anhydrase inhibitors, and osmotic diuretics. It describes the mechanisms of action, pharmacokinetics, uses, and adverse effects of these diuretic classes with a focus on furosemide, hydrochlorothiazide, acetazolamide, spironolactone, triamterene, and mannitol. Key sites of action in the nephron are identified for each drug class.
The document provides information on drugs acting on the genitourinary system. It discusses several classes of drugs including antidiuretics, diuretics, 5-alpha reductase inhibitors, alpha blockers, anti-infectives, antigout agents, and spermicides. Specifically, it describes the mechanisms, indications, and side effects of antidiuretics like vasopressin and various classes of diuretics including loop diuretics, thiazide diuretics, and potassium-sparing diuretics. It also includes a section on research evidence regarding the use of terlipressin and albumin for hepatorenal syndrome.
This document provides an overview of diuretics, including their definition, classification, mechanisms of action, and side effects. It discusses the physiology of urine formation and the roles of the kidney in homeostasis. Specific sections cover thiazide diuretics, loop diuretics, their mechanisms in inhibiting sodium reabsorption in the distal tubule and thick ascending limb, respectively. Adverse effects include hypokalemia, hyperuricemia, and effects on calcium and magnesium levels. The document compares the potencies and durations of action of different diuretic classes and individual drugs.
The document discusses human renal physiology and diuretics. It covers the key functions of the kidney - filtration, reabsorption, secretion and excretion. It then describes different types of diuretics and how they work, including loop diuretics, potassium sparing diuretics, high ceiling diuretics, osmotic diuretics, thiazide diuretics and carbonic anhydrase inhibitors. Potential side effects of diuretic use are also outlined. The document concludes by discussing antidiuretics like ADH/vasopressin and synthetic forms like desmopressin, as well as lythotriptics and hepatoprotection.
Loop diuretics work by selectively inhibiting sodium chloride reabsorption in the thick ascending limb of Henle's loop. This makes them highly effective diuretic agents. They are rapidly absorbed and eliminated by the kidneys. Common loop diuretics include furosemide, bumetanide, and torsemide. Loop diuretics are used to treat conditions causing edema such as heart failure, as well as hyperkalemia and acute renal failure. Potential side effects include hypokalemia, ototoxicity, and hypomagnesemia with prolonged use.
This document discusses drugs used to treat various gastrointestinal conditions. It describes several classes of antiemetic drugs that work through different mechanisms to prevent or relieve nausea and vomiting, including H1 antagonists, muscarinic receptor antagonists, dopamine antagonists, and 5HT3 antagonists. It also discusses the antiemetic metoclopramide and the prokinetic domperidone. Other sections cover prokinetic drugs, anti-spasmodics, anti-cholinergic drugs, laxatives (including their classifications and examples), and treatments for diarrhea like oral rehydration solutions and non-specific antidiarrheal drugs such as adsorbents and opiates.
This PPT covers drugs used as diuretics. Pharmacotherapy of all drugs used as diuretics are covered here. Thiazides, high ceiling, aldosterone antagonist, osmotic diuretics are explained
This document provides information about different types of diuretic drugs, including their mechanisms of action, therapeutic uses, and side effects. It discusses loop diuretics like furosemide that act in the thick ascending limb of the loop of Henle, thiazide diuretics like hydrochlorothiazide that act in the distal convoluted tubule, potassium-sparing diuretics like spironolactone that act in the collecting duct, and carbonic anhydrase inhibitors like acetazolamide. The document explains how each class of diuretic increases urine output and outlines their applications in conditions like heart failure, hypertension, and edema. It also notes common adverse effects like hypokalemia, hy
This document discusses different classes of diuretics. It begins by classifying diuretics as high ceiling, medium efficacy, or weak/adjunctive. It then describes the mechanisms and uses of various weak diuretics, including carbonic anhydrase inhibitors like acetazolamide, osmotic diuretics, potassium sparing diuretics, and renal epithelial sodium channel blockers. It discusses how each works and their potential adverse effects and drug interactions. The document concludes with reviewing the key points and reminding students to prepare for the next practical class by revising topics from their book.
This document provides an overview of diuretics, including their definition, classification, mechanisms of action, and pharmacology. It focuses on the physiology of urine formation and the mechanisms and sites of action of thiazide and loop diuretics. Thiazide diuretics act in the early distal tubule by inhibiting sodium-chloride reabsorption, while loop diuretics act in the thick ascending limb of the loop of Henle by blocking the sodium-potassium-chloride transporter. The document compares the mechanisms, indications, doses, side effects and drug interactions of thiazide and loop diuretics.
The document discusses different classes of diuretic drugs, including their mechanisms and effects. It describes loop diuretics like furosemide that inhibit sodium chloride reabsorption in the thick ascending limb of Henle's loop, increasing excretion of sodium and chloride in urine. It also discusses thiazide diuretics that act in the early distal tubule by inhibiting carbonic anhydrase and enhancing excretion of magnesium and potassium while inhibiting calcium and uric acid excretion. Finally, it mentions osmotic diuretics like mannitol that cause water retention in the proximal tubule through osmotic effects, resulting in water diuresis.
Diuretic agents work by increasing urine output and sodium excretion. There are several classes of diuretics including carbonic anhydrase inhibitors, loop diuretics, osmotic diuretics, potassium-sparing diuretics, and thiazide diuretics. Nursing care involves monitoring for therapeutic and adverse effects such as hypokalemia, hypotension, and fluid imbalance.
Drugs used in gastrointestinal system for PCLsarosem
This document discusses drugs used in the gastrointestinal system including antiemetics, antidiarrheals, laxatives, and drugs that reduce gastric acid. It provides details on common drugs in each category such as metoclopramide and ondansetron for antiemetics, loperamide for antidiarrheals, and proton pump inhibitors like omeprazole for gastric acid reduction. Nursing considerations are also outlined for the administration and monitoring of these gastrointestinal drugs.
This document discusses different classes of diuretic drugs, including their sites of action in the nephron, mechanisms of action, therapeutic uses, and side effects. It covers osmotic diuretics, carbonic anhydrase inhibitors, thiazide diuretics, loop diuretics, and potassium-sparing diuretics. The main points are that diuretics work by inhibiting transport in different parts of the nephron like the proximal tubule, loop of Henle, or distal convoluted tubule. They are used to treat conditions like edema, hypertension, and heart failure. Common side effects among the classes include electrolyte imbalances and metabolic alterations.
This document summarizes antidiarrheal and laxative drugs, including their mechanisms of action, uses, side effects, and nursing considerations. It describes different types of antidiarrheal drugs like adsorbents, anticholinergics, and opiates that work by coating the GI tract, decreasing intestinal motility, or decreasing bowel transit time. It also outlines various laxative categories including bulk-forming, emollient, hyperosmotic, saline, and stimulant laxatives and how they work to treat constipation. Nursing priorities are discussed like assessing for electrolyte imbalances, encouraging diet and fluid changes over long-term laxative use, and monitoring for therapeutic effects and side effects
Diuretics work by inhibiting reabsorption of sodium and water in the kidneys, increasing urine output. There are several types of diuretics that act in different parts of the kidney: loop diuretics act in the ascending limb of Henle's loop, thiazide diuretics act in the distal convoluted tubule, and potassium-sparing diuretics act in the cortical collecting tubule. Diuretics are used to treat conditions like heart failure, liver failure, renal failure, and hypertension by mobilizing edema fluid and maintaining urine volume. Common side effects include hypokalemia, hyperglycemia, and increased uric acid levels.
The document discusses diuretics, which are drugs that increase urine production. It defines diuretics and describes their primary mechanism of action as inhibiting sodium reabsorption along the nephron. This leads to increased sodium and water excretion, reducing extracellular fluid volume and edema. The document classifies major types of diuretics, including carbonic anhydrase inhibitors, loop diuretics, thiazides, and potassium-sparing diuretics. It provides examples of drugs for each class, along with their uses, mechanisms, and side effects. Structure-activity relationships that determine diuretic activity are also summarized.
This document discusses different types of diuretic drugs, how they work, and their uses. It covers high-ceiling loop diuretics which inhibit sodium reabsorption; thiazide diuretics which inhibit sodium transport in the distal convoluted tubule; carbonic anhydrase inhibitors which reduce hydrogen ion secretion; potassium-sparing diuretics which act in the cortical collecting duct; and osmotic diuretics like mannitol. Diuretics are used to treat conditions causing fluid retention like heart failure and liver disease. Side effects include electrolyte abnormalities and dehydration. Loop diuretics are commonly used for heart failure but may require intravenous administration for severe cases.
This document discusses various classes of diuretic drugs including loop diuretics, thiazide diuretics, thiazide-like diuretics, potassium-sparing diuretics, carbonic anhydrase inhibitors, and osmotic diuretics. It describes the mechanisms of action, pharmacokinetics, uses, and adverse effects of these diuretic classes with a focus on furosemide, hydrochlorothiazide, acetazolamide, spironolactone, triamterene, and mannitol. Key sites of action in the nephron are identified for each drug class.
The document provides information on drugs acting on the genitourinary system. It discusses several classes of drugs including antidiuretics, diuretics, 5-alpha reductase inhibitors, alpha blockers, anti-infectives, antigout agents, and spermicides. Specifically, it describes the mechanisms, indications, and side effects of antidiuretics like vasopressin and various classes of diuretics including loop diuretics, thiazide diuretics, and potassium-sparing diuretics. It also includes a section on research evidence regarding the use of terlipressin and albumin for hepatorenal syndrome.
This document provides an overview of diuretics, including their definition, classification, mechanisms of action, and side effects. It discusses the physiology of urine formation and the roles of the kidney in homeostasis. Specific sections cover thiazide diuretics, loop diuretics, their mechanisms in inhibiting sodium reabsorption in the distal tubule and thick ascending limb, respectively. Adverse effects include hypokalemia, hyperuricemia, and effects on calcium and magnesium levels. The document compares the potencies and durations of action of different diuretic classes and individual drugs.
The document discusses human renal physiology and diuretics. It covers the key functions of the kidney - filtration, reabsorption, secretion and excretion. It then describes different types of diuretics and how they work, including loop diuretics, potassium sparing diuretics, high ceiling diuretics, osmotic diuretics, thiazide diuretics and carbonic anhydrase inhibitors. Potential side effects of diuretic use are also outlined. The document concludes by discussing antidiuretics like ADH/vasopressin and synthetic forms like desmopressin, as well as lythotriptics and hepatoprotection.
Loop diuretics work by selectively inhibiting sodium chloride reabsorption in the thick ascending limb of Henle's loop. This makes them highly effective diuretic agents. They are rapidly absorbed and eliminated by the kidneys. Common loop diuretics include furosemide, bumetanide, and torsemide. Loop diuretics are used to treat conditions causing edema such as heart failure, as well as hyperkalemia and acute renal failure. Potential side effects include hypokalemia, ototoxicity, and hypomagnesemia with prolonged use.
This document discusses drugs used to treat various gastrointestinal conditions. It describes several classes of antiemetic drugs that work through different mechanisms to prevent or relieve nausea and vomiting, including H1 antagonists, muscarinic receptor antagonists, dopamine antagonists, and 5HT3 antagonists. It also discusses the antiemetic metoclopramide and the prokinetic domperidone. Other sections cover prokinetic drugs, anti-spasmodics, anti-cholinergic drugs, laxatives (including their classifications and examples), and treatments for diarrhea like oral rehydration solutions and non-specific antidiarrheal drugs such as adsorbents and opiates.
This PPT covers drugs used as diuretics. Pharmacotherapy of all drugs used as diuretics are covered here. Thiazides, high ceiling, aldosterone antagonist, osmotic diuretics are explained
This document provides information about different types of diuretic drugs, including their mechanisms of action, therapeutic uses, and side effects. It discusses loop diuretics like furosemide that act in the thick ascending limb of the loop of Henle, thiazide diuretics like hydrochlorothiazide that act in the distal convoluted tubule, potassium-sparing diuretics like spironolactone that act in the collecting duct, and carbonic anhydrase inhibitors like acetazolamide. The document explains how each class of diuretic increases urine output and outlines their applications in conditions like heart failure, hypertension, and edema. It also notes common adverse effects like hypokalemia, hy
This document discusses different classes of diuretics. It begins by classifying diuretics as high ceiling, medium efficacy, or weak/adjunctive. It then describes the mechanisms and uses of various weak diuretics, including carbonic anhydrase inhibitors like acetazolamide, osmotic diuretics, potassium sparing diuretics, and renal epithelial sodium channel blockers. It discusses how each works and their potential adverse effects and drug interactions. The document concludes with reviewing the key points and reminding students to prepare for the next practical class by revising topics from their book.
This document provides an overview of diuretics, including their definition, classification, mechanisms of action, and pharmacology. It focuses on the physiology of urine formation and the mechanisms and sites of action of thiazide and loop diuretics. Thiazide diuretics act in the early distal tubule by inhibiting sodium-chloride reabsorption, while loop diuretics act in the thick ascending limb of the loop of Henle by blocking the sodium-potassium-chloride transporter. The document compares the mechanisms, indications, doses, side effects and drug interactions of thiazide and loop diuretics.
The document discusses different classes of diuretic drugs, including their mechanisms and effects. It describes loop diuretics like furosemide that inhibit sodium chloride reabsorption in the thick ascending limb of Henle's loop, increasing excretion of sodium and chloride in urine. It also discusses thiazide diuretics that act in the early distal tubule by inhibiting carbonic anhydrase and enhancing excretion of magnesium and potassium while inhibiting calcium and uric acid excretion. Finally, it mentions osmotic diuretics like mannitol that cause water retention in the proximal tubule through osmotic effects, resulting in water diuresis.
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This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
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This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
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3. Definition
Greek - "dia-", thoroughly +
"ourein", to urinate = to urinate thoroughly
Diuretics are the drugs which increase the rate
of urine formation causing a net loss of
solute (mainly NaCl) along with equivalent
volume of water, by interfering with
transport mechanism responsible for the
reabsorption of solutes from various
segments of the nephron.
4. *
These are drugs which cause a net loss of
Na+ and water in urine
There are several categories of diuretics.
All diuretics increases the excretion of
water from body
NATRIURETICS: Substance that promotes
the renal excretion of Na+
5. a. Edema, CHF, pregnancy & nutritional
b. Nephrotic syndrome
c. Diabetes insipidus
d. Hypertension
e. Cirrhosis of liver
f. And also lower the intracellular and CSF
pressure.
Diuretics are very effective in the treatment
of :
6. •KIDNEY:
>Weight-0.5% of body,
>Receive 25% of cardiac output (50 times)
>Each kidney contain 1.3 million nephron
• KIDNEY FUNCTIONS:
>Balance of electrolytes,Plasma volume, Acid
–base
>Activation of vitamin D
>Synthesis of Erythropoietin,Urokinase
>Excretion of Urea, Uric acid, Creatinine etc.
7. •Tubular reaborption:
>Reabsorption of 99% of glomerular filtrate-
only ±1 ml/min excreted as urine
>1.5L/day of urine
• Glomerular filtration:
>Receive 25% of cardiac output
>Filtration rate: 100-120 ml/minute
>180 L of glomerular filtrate/day
• Tubular secretion
8.
9.
10.
11. • Proximal tubules:
>Reabsorption of 60-70% Na+
>Permeable to water– isotonic urine
>Active absorption of Nacl,NaHCO3,glucose,amino
acids, organic solutes
• Loop of Henle:
>Thin descending limb: most active water
reabsorption
>Thick ascending limb: reabsorption of Na+,
impermeable to water
12. • Distal Tubule:
>Na+ reabsorption
>Calcium excretion is regulated
• Collecting duct:
>Selectively water permeable
21. Loop diuretics are active on loop of henle(thick
ascending limb)
FUROSEMIDE(FRUSEMIDE)
It is a prototype drug
It is a sulfonamide derivative
It is the most powerful diuretics
22. Mechanism of action
FUROSEMIDE
Enter proximal tubule via organic acid
transporter
It blocks the Na+ K+ 2Cl- cotransport in the
thick asending limb
Competes with Cl- binding site
Enhances the Mg2+,Ca2+,K+&H+ excretion
23. It inhibits NaCl- reabsorption in the thick
ascending limb
It inhibits reabsorption of ~25% of glomerular
filtrate
24. Pharmacokinetics
• Furosemide are administered orally
• Furosemide and other loop diuretics are
rapidly and almost completely absorbed
• They are extensively bound to plasma
proteins
• They are partly metabolized in the liver and
the metabolites are excreted by urine
Adverse effects
• Hypokalaemia
• Metabolic alkalosis
• Hyponatraemia
• Hyperuricaemia
25. • Ototoxicity
• Hypomagnesaemia
• Hypocalcaemia
Therapeutic uses
• They are highly effective for the relief of
oedema of all origins like cardiac, hepatic or
renal oedema
• Used for the treatment of acute renal failure
• Furosemide is used as an alternative to or in
combination with osmotic diuretics
• Used for the treatment of hypertension,
hypercalcaemia and hyperkalaemia
26. Drug interactions
• It may increase the ototoxic potential of
aminoglycoside antibiotics, especially in
the presence of impaired renal function
• Furosemide combined with angiotensin
converting enzyme inhibitor thus may
lead to severe hypotention
Contraindication
• Pronounced hyponatremia and anuria
27. Thiazide diuretics are active in distal
convoluted tubule
Thiazide are medium efficacy diuretics
Chlorothiazide was the first thiazide to be
synthesized
All thiazide have a sulfonamide group
28. Mechanism of action
THIAZIDES
Reach distal convoluted tubule
Bind to and block Na+ Cl- symport system
Increase the excretion of Na+ Cl-
Also increase the excretion of K+ and Mg2+
Decrease the excretion of Ca2+ and uric acid
29.
30. Pharmacokinetics
Thiazide are well absorbed after oral
administration
Rapid acting with in 60 minutes
Duration of action varies from 6-48 hours
They are excreted in urine
Adverse effects
Hypokalaemia
Hyperglycaemia
Metabolic alkalosis
Hyperuricaemia
Hyponatraemia
31. Hypercalcaemiae
Fatigue
Anorexia
GI disturbances
Allergic reactions
Therapeutic uses
Thiazides are the first line drugs for
treatment of hypertension
They are used for treatment of CHF
Hypercalciuria with renal stones can be
treated with thiazides which reduce calcium
excretion
Treatment of nephrogenic diabetes insipidus
32. Drug interaction
• It combine with digitalis glycosides ,they
induce the hypokalemia and hypomagnesemia
and cause digitalis toxicity
• It combines with lithium and decrease the
lithium clearance and cause lithium toxicity
Contraindication
• It is contraindicated in pregnancy, they may
reduce the maternal uterine blood flow
• It is also contraindicated in diabetes
pregnant women
33. They are active in proximal tubule
They are limited uses of diuretics
ACETAZOLAMIDE
It is a prototype drug
It is a sulfonamide
derivative
34. Mechanism of action
ACETAZOLAMIDE
Bind to and inhibits enzymes carbonic anhydrase
Blocks NaHCO3- reabsorption
Increases the excretion of Na+, K+, HCO3- and
water
35.
36. Pharmacokinetics
Acetazolamide is well absorbed orally
Onset of action is with in 60-90 minutes
Duration of action is 8-12 hour
It is excreted in unchanged urine
Adverse effects
Metabolic acidosis
Hypokalaemia
Drowsiness
Paraesthesia(pain due to pins & needles
under the skin)
Skin rashes
37. Therapeutic uses
Acetazolamide decrease the intraocular
pressure, hence used to treat glaucoma
Used to alkalinize the urine
Acetazolamide is used mainly as
prophylactic agent in acute mountain
sickness
Acetazolamide is used as an adjuvant in
epilepsy
38. Drug interaction
• It combined with warfarin which
decrease the metabolism rate
• It combined with 2,4 thiazolidinedione
which decrease the excretion rate
Contraindication
• It is contraindicated in situation in which
sodium or potassium blood serum levels
are depressed ,in cases of liver disease
39. Potassium sparing diuretics may act by two
ways
Aldosterone antagonists
Spironolactone
Inhibitors of renal epithial Na+
channel
Triamterene
Amiloride
40. Mechanism of action
SPIRONOLACTONE
Enter the cell and bind to specific
mineralocorticoid receptor(MR) in DT and CD
cells
Inhibit action of aldosterone
Increases the Na+ and water excretion,
decreases the K+ loss
41. AMILORIDE/TRIAMTERENE
They block the Na+ transport through the
sodium channels in the luminal membrane
Increases the Na+ and water excretion ,
decreases the K+ loss
42.
43. Pharmacokinetics
spironolactone
Orally administered
It is highly bound to plasma proteins
Completely metabolized in liver, converted
to active metabolites
Amiloride
Oral administration, 50% effective
not metabolized
not bound to plasma proteins
44. Triamterene
It is incompletely absorbed orally
Partly bound to plasma proteins
Largely metabolized in liver to an active
metabolite and excreted in urine
Adverse effects
Spironolactone
Hyperkalaemia
Drowsiness
Confusion
Gynaecomastia
Hirsutism
46. Therapeutic uses
Potassium sparing diuretics are used with
thiazides/loop diuretics for treatment of
hypertension
The combination therapy increases the
diuretics and antihypertensive effect
They are used to treat cirrhosis and CHF
To counteract K+ loss due to thiazide and
loop diuretics
47. Drug interaction
• It interact with lithium , that may increase
the level of potassium in the blood
• It also interact with ACE inhibitor, digoxin
and steroids like prednisone
Contraindications
• It contraindicated in the patients with
hyperkalemia, Addison's disease
48. Osmotic diuretics are not interact with receptors
or directly block the renal transport
Activity dependent on development of osmotic
pressure
MANNITOL
It is a prototype drug
It is pharmacologically inert ,so
can be given in large quantities
sufficient to rise osmolarity of
plasma and tubular fluid
49. Mechanism of action
MANNITOL
Increases osmolarity of plasma
Shift of fluid(osmotic effect) from the
intracellular compartment(ICC) to extracellular
fluid(ECF)
Expansion of ECF volume
Increases glomerular filtration rate, mannitol
is freely filtered at the glomerulus
50. Increases osmolarity of tubular fluid
Inhibits reabsorption of water and
NaCl-
The net effect is increased urinary excretion of
Na+, K+, Ca2+, Mg2+, and CL-
51. Pharmacokinetics
Mannitol is administered intravenously
It is neither metabolized in the body nor
reabsorbed from the renal tubules
It is pharmacologically inert and is freely
filtered at the glomerulus
Adverse effects
Hyponatraemia
Pulmonary oedema
Headache
Nausea
vomiting
52. Therapeutic uses
It is used to reduce the elevated intracranial
tension following head injury or tumour
It is used both pre and post-operatively to
reduce the elevated IOP in acute congestive
glaucoma
Mannitol is used to produce diuresis in case
of poisoning
Mannitol is used to prevent acute renal
shutdown in shock, cardiovascular surgery,
haemolytic transfusion reactions ect..
53. Drug interaction
• It interact with depression medications like
Effexor and Lexapro
• It also interact with diabetes drug like
TANZEUM
Contraindications
• Anuria
• Pulmonary edema
• Severe dehydration
• Intracranial haemorrhage
54. Essential of medical pharmacology by KD
Tripathi 7th edition.
Text book Pharmacology by padmaja
udaykumar.
https://youtu.be/NzdvoGZquIk
https://youtu.be/oh0nAyW5r5Y