Diuretics PDF

(to able urination) ↑ urinary flow rates DiuretiCS -+ Na3CI reabsorption ↓ ↑ 3 salt...

(to able urination) ↑ urinary flow rates DiuretiCS -+ Na3CI reabsorption ↓ ↑ 3 salt water loss ③ > Thiazide mannitol I ④ - L Kalium Carbonic sparring anhydrase Y ADH antagonist ① Y Furosemide way needed ? · edema associated with congestive a failure acute edema pulmonary · · liver disease (obstructed blood flow-pressure in hepatic vessel · renal disease · hypertension hyperkalaemia ·  Proximal tubule diuretics · Carbonic anhydrase inhibitor · Inhibit CA · Inhibit NatCOs reabsorption > - ↓ HCO3 Clinical use - Acetazolamide (Diamox ( Glaucoma ( ↓ aqueous humour formation > ↓ intraocular · pressure - · Urine alkalinization (weak acid drugs excretion) · Metabolic Alkalosis ( N k3 intravascular volume , ↑ mineralcorticoid) · Acute mountain sickness (VCSF ↓ , PHCSF) - Adverse reaction other Hypercholeremic metabolic acidosis O [drowsy , hypersensitivity (v body bicarbonate) H K R Renal 1 wasting Renal stones Ca l+ excretions (phosphaturia Shypercalciuria) HK RO  Osmotic diuretics · ↑ water excretion · PT ↳ descending loop of Henle Mannitol · limit water reabsorption (PT13 descending LOH ↓ water diuresis intracranial pressure 3 ↓ · no Metabolism & glomerular filtration (parenteral-diuretic effect oral for osmotic diarrhea - + activated charcoal) (most effective high ceiling diuretic Loop - diuretics (natural) · inhibit Nall reabsorption in Lot Furosemide , Bumetanide , Torsemide , Ethacrynic acid · inhibit Nat-k+ Cl - transport system Clinical uses ( * kexcretion) hyperkalemia hypercalcamia · Acute edema o pulmonary · mild hypertension (Piretamide) · acute renal failure (Furosemide , NRBF , 44 excretion · Anion poisoning treatment (Br , F11 / reabsorbed in Lot ascending 3 Adverse reactions - > dehydration hyponattia Hypokalemia metabolic ! !! alkalosis ( ↑ salts water in CT) Allergic reaction ! * Ototoxicity Hypomagnesemia Hyperuricacemia CV uric acid excretion  Distal Convoluted Tubule Diuretics Thiazide o inhibits Nacl reabsorption from luminal DCT (Benzothiazides) o & cat reabsorption in DCT - Chlorothiazide /lipid insoluble , ↑ dose -Chlortalidone (slow absorption , long acting Clinical use · mild heart failure hypertension· Nephrogenic diabetes o prevent recurrent stone formation insipidus Hypokalemic metabolic Adverse actions - - alkalosis + hyperuricaemia hyponatremia fatigue 1 I ↳ Carbohydrate tolerance Allergic reaction failure hyperglycemia - - hyperlipidemia  Collecting Duct Diuretics I Kalium ADH Antagonists sparring aldosterone inhibit effects · antagonist o ADH at collecting tubule (cortical (D + last distal tubule baldosterone regulates Nat absorption 3k + excretion · Non selective mineral corticoid ↳ Lit ↳ receptor Demeclocycline · (Spironolactone aldactone - · Nat channels transportation Clinical uses (Triamterene Dyrenium - · Syndrome of Inappropriate ADH (SIADH) (Amiloride - Midamor Clinical uses - Adverse reaction · heart failure I ↳ · · hyperaldosteronism hepatic cirrhosis primary Nephrogenic Insipidus diabetes ! Headachee cardiac nausea toxicity , Adverse Reaction Renal Failure S b (polyurial Hyperkalemia Acute renal failure ! ! ↓ Hypercholeremic Metabolic Acidosis Kidney Stone Gynecomastia Other : Xanthines ↳ Caffein , Theophylline o M Cardiac output & RBF + GFR , o ↓ Na , C1 3 water loss