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    1. Diuretics work at different segments of the nephron to promote excretion of water and ions like sodium, potassium, and chloride. They are classified based on their site and mechanism of action. 2. Loop diuretics like furosemide work in the thick ascending limb of the loop of Henle by inhibiting the Na-K-2Cl transporter. They are highly effective at promoting natriuresis but can cause hypokalemia. 3. Thiazide diuretics like hydrochlorothiazide work in the distal convoluted tubule by inhibiting the sodium-chloride transporter and are used to treat hypertension and reduce intraocular pressure. They can also cause

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    Pharmacology Reviewer for Diuretics

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    1. Diuretics work at different segments of the nephron to promote excretion of water and ions like sodium, potassium, and chloride. They are classified based on their site and mechanism of action. 2. Loop diuretics like furosemide work in the thick ascending limb of the loop of Henle by inhibiting the Na-K-2Cl transporter. They are highly effective at promoting natriuresis but can cause hypokalemia. 3. Thiazide diuretics like hydrochlorothiazide work in the distal convoluted tubule by inhibiting the sodium-chloride transporter and are used to treat hypertension and reduce intraocular pressure. They can also cause

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    32 views2 pages

    Cvs (Diuretics)

    Uploaded by

    Cat
    1. Diuretics work at different segments of the nephron to promote excretion of water and ions like sodium, potassium, and chloride. They are classified based on their site and mechanism of action. 2. Loop diuretics like furosemide work in the thick ascending limb of the loop of Henle by inhibiting the Na-K-2Cl transporter. They are highly effective at promoting natriuresis but can cause hypokalemia. 3. Thiazide diuretics like hydrochlorothiazide work in the distal convoluted tubule by inhibiting the sodium-chloride transporter and are used to treat hypertension and reduce intraocular pressure. They can also cause

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    of 2

    CVS: Diuretics


    Segments 3. L O O P D I U R E T I C S ( h i g h _ - c e i l i n g
    diuretics)
    SEGMENT FUNCTION TRANSPORTER DRUGS
    ‣ Furosemide
    Proximal Reabsorpti
    Convoluted on of Na+ /
    Na/H (NHE3), Carbonic ‣ Torsemide
    carbonic anhydrase
    tubule K+/ Ca2+/ & ‣ Ethacrynic acid
    anhydrase inhibitors
    (PCT) Mg2+
    4. K+-SPARING DIURETICS
    Active
    reabsorption ‣ Amiloride
    Thick
    of Na+ /
    ascending ‣ Triamterene
    K+/ Cl+; Na/ K/ 2Cl Loop
    limb of
    henge
    Secondary (NKCC2) diuretics ‣ Spironolactone
    absorption
    (TAL)
    of Ca2+ &
    5. OSMOTIC DIURETICS
    Mg2+ ‣ Mannitol IV
    Distal Active 6. VASOPRESSIN ANTAGONITS
    Convoluted reabsorption Na/Cl
    tubule of Na+ / (NCC)
    Thiazides ‣ Conivaptan
    (DCT) Ca2+/ Cl+; ‣ Tolvaptan
    Na+ Na channels
    Cortical
    reabsorption (ENaC), K K+
    collecting
    tubule
    coupled to channel, H+ sparing USES
    K+ & H+ transporter, diuretics
    (CCT) 1. HYPERTENSION
    secretion Aquaporins

    Water 2. GLAUCOMA
    Medullary
    reabsorption
    collecting Vasopressin ‣ Acetazolamide
    under Aquaporins
    duct antagonists
    (MCT)
    vasopressin ‣ Mannitol IV
    control
    3. REDUCE INTRACRANIAL PRESSURE
    ‣ Mannitol IV
    CLASS 4. TREATMENT OF SYNDROME OF
    1. CARBONIC ANHYDRASE INHIBITORS INAPPROPRIATE ADH SECRETION

    ‣ Acetazolamide (SIADH)
    ‣ Brinzolamide ‣ Demeclocycline
    ‣ Dorzolamide 5. T R E A T M E N T O F P O T A S S I U M
    2. THIAZIDE DIURETICS W A S T I N G A S S O C I AT E D W I T H

    ‣ Hydrochlorothiazide (HCTZ) THIAZIDE/LOOP

    ‣ Chlorthalidone ‣ K+- sparing diuretics


    6. T R E A T M E N T OF Osmotic Remains in
    Hypo/hyper
    HYPERALDOSTERONISM diuretics the lumen
    natremia
    Aldosterone antagonists (Mannitol) “holds” water
    ‣
    ✴ ALL DIURETICS may cause
    ADVERSE EFFECTS hyponatremia, hypotension, &
    dehydration
    ADVERSE
    DRUG CLASS MOA ✴ In MANNITOL, hyponatremia occurs
    EFFECTS
    when water is withdrawn from the cells,
    METABOLIC
    Carbonic Hypernatremia occurs when water is
    Inhibits ACIDOSIS,
    anhydrase excreted out the urine
    carbonic alkalinazation
    inhibitors
    anhydrase of urine, low
    (acetazolamide)
    potassium
    DRUG INTERACTION
    Low K+, Ca2+,
    1. Furosemide + Aminoglycosides =
    Mg2+,
    elevated INCREASE ototoxicity
    blood sugar, 2. Furosemide + NSAIDS = reduce diuretic
    Loop
    Inhibits Hyperlipidemia
    Diuretics effect
    (furosemide)
    NAKCC2 , ototoxicity, Loop
    Sulfonamide 3. K-sparing diuretics + ACE inhibitors =
    allergy, hyperkalemia
    METABOLIC
    ALKALOSIS

    Low K+,
    Mg2+, High
    Ca2+,
    Elevated
    Thiazide blood sugar
    Diuretics Inhibits NCC and uric acid,
    (HCTZ) Hyperlipidemia
    , Sulfonamide
    allergy,
    METABOLIC
    ALKALOSIS

    a.Inhibits Na+
    Hyperkalemia,
    influx
    METABOLIC
    • Triamterene
    • Amiloride ACIDOSIS,
    K+-sparing
    Gynecomastia
    diuretics
    b. Antagonizes ,
    aldosterone Antiandrogenic
    • Spironolactone
    effects
    • Eplerenone

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