Concept About Diuretics – This book covers the entire syllabus of “Pharmacology” prescribed by BNMC- for diploma in nursing science & midwifery students. We tried to accommodate the latest information and topics. This book is an examination setup according to the teachers’ lectures and examination questions.
At the end of the book, previous questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourish. The unique way of presentation may make your reading of the book a pleasurable experience.
Concept About Diuretics
Renal Pharmacology
➤ Kidneys comprise only 0.5% of body-weight, yet they receive 25% of cardiac output.
➤Urine formation starts from glomerular filtration (g.f.) in a prodigal way. Normally, about 180 L of fluid is filtered everyday: all soluble constituents of blood minus the plasma proteins (along with substances bound to them) and lipids, are filtered at the glomerulus. More than 99% of the glomerular filtrate is reabsorbed in the tubules; about 1.5 L urine is produced in 24 hours.
Diuretics
Diuretics:
Diuretics (natriuretics) are drugs which cause a net loss of Na+ and water in urine.
An increase in urine volume is called diuresis
Diuresis:
AHO An increase in renal sodium excretion (and so, does increase water excretion) is called natriuresis.
Natriuresis:
Diuretics are among the most widely prescribed drugs. Application of diuretics in the management of hypertension has outstripped their use in edema. Availability of diuretics has also had a major impact on the understanding of renal physiology.
Classification
- According to efficacy:
- High efficacy diuretics (Inhibitors of Na+-K+-2CI cotransport)
- Sulphamoyl derivatives
➤ Furosemide
➤Bumetanide
➤Torasemide
- Medium efficacy diuretics (Inhibitors of Na+-Cl symport)
- Benzothiadiazines (thiazides)
➤ Hydrochlorothiazide
➤Benzthiazide
➤ Hydroflumethiazide
➤ Bendroflumethiazide
- Thiazide like (related heterocyclics)
➤ Chlorthalidone
➤ Metolazone
➤ Xipamide
➤ Indapamide
➤ Clopamide
- Weak or adjunctive diuretics
- Carbonic anhydrase inhibitors
➤Acetazolamide
- Potassium sparing diuretics
➤ Aldosterone antagonist:
➤Spironolactone, Eplerenone
➤Inhibitors of renal epithelial Na+ channel: Triamterene, Amiloride.
- Osmotic diuretics
➤ Mannitol, Isosorbide, Glycerol
- According to site of action:
- Site (PCT):
➤Osmotic diuretics:
➤ Mannitol
➤ Isosorbide
➤ Urea
Carbonic anhyrdrase inhibitors
➤ Acetazolamide
➤ Dichlorphenamide
- Site-II (ALLH): High-ceiling diuretics:
- Frusemide
- Bumetamide
- Ethacrynic acid
- Piretanide
- Site-III (DCT): Moderate efficacy diuretics:
- Thiazide
- Mercurial compounds
- Site-IV (Collecting duct): K* sparing diuretics:
- Spironolactone (aldosterone antagonists)
- Triamterene
- Amiloride
High Ceiling (Loop) Diuretics
(Inhibitors of Na+-K+-2CI Cotransport) High ceiling (efficacy) diuretics (loop diurerics) are:
➤ Frusemide
➤ Bumetanide.
➤ Ethacrynic acid
➤ Piretanide.
Read more: