Diuretics: DR Mozna Talpur
Diuretics: DR Mozna Talpur
Diuretics: DR Mozna Talpur
Dr Mozna Talpur
DIURETICS
Osmotic diuretics
Potassium-sparing diuretics
Adverse Effects:
Metabolic acidosis
Anorexia
Hematuria Hypokalemia
Drowsiness
Melena Paresthesia
Urticaria
LOOP DIURETICS
LOOP DIURETICS
Generally cause greater diuresis than thiazides; used
when they are insufficient.
Can enhance Ca2+ and Mg2+ excretion
Furosemide
Dehydration
Thiazide diuretics
Hydrochlorothiazide
Chlorothiazide
Trichlormethiazide
Thiazide-like diuretics
Chlorthalidone
Metolazone
THIAZIDE AND THIAZIDE-LIKE DIURETICS
MECHANISM OF ACTION
Acts in the distal convoluted tubule.
Inhibit tubular resorption of sodium, chloride, and potassium ions
Result: water, sodium, and chloride are excreted
Results:
Lowered peripheral vascular resistance
Sodium, water, chloride and potassium are excreted
THIAZIDE AND THIAZIDE-LIKE DIURETICS
PRECAUTIONS
Hypertension.
Adjunct drugs in treatment of edema related to HF, hepatic cirrhosis,
corticosteroid therapy.
Idiopathic hypercalciuria, Patients with calcium oxalate stones.
Diabetes insipidus(Act As ADH, causes concentrated urine)
THIAZIDE AND THIAZIDE-LIKE DIURETICS
ADVERSE EFFECTS
Metabolic: Hypokalemia, glycosuria, hyperglycemia,
Decrease insulin release from pancreas), hyperuricemia
(Contra indicated in gout)
Amiloride
Spironolactone
Triamterene
Amiloride
Treatment of HF
POTASSIUM-SPARING DIURETICS
ADVERSE EFFECTS
Hyperkalemia
GI: Cramps, nausea,vomiting, diarrhea
CNS: Dizziness, headache
Other: Urinary frequency, weakness, loss of libido.
POTASSIUM-SPARING DIURETICS
ADVERSE EFFECTS
Spironolactone
Gynecomastia
Amenorrhea
Irregular menses
Postmenopausal bleeding
OSMOTIC DIURETICS
Osmotic agents (proximal tubule, descending loop
of Henle, collecting duct)
Reduce pre-surgical or post-trauma intracranial pressure
Prompt removal of renal toxins
One of the few diuretics that do not remove large amounts
of Na+
Can cause hypernatremia
OSMOTIC DIURETICS
No interaction with transport systems
All activity depends on osmotic pressure exerted in
lumen
Blocks water reabsorption in proximal tubule,
descending loop, collecting duct
Results in large water loss, smaller electrolyte loss
can result in hypernatremia
DIURETICS
OSMOTIC DIURETICS -- INDICATIONS
Used in the treatment of patients in the early, oliguric phase of ARF
Convulsions
Thrombophlebitis
Pulmonary congestion
Mannitol
Carbonic anhydrase
Acetazolamide PCT
inhibitors