Diuretic Agents

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Sulfonamide similar to thiazide
Popular for use with loop agents for synergistic effects
MOA: Physical osmotic effect on tissue water distribution because it is retained in the vascular compartment
MOA: Inhibition of the enzyme prevents dehydration of H2CO3 and hydration of CO2
Clinical applications: glaucoma, mountain sickness, edema with alkalosis
Not a sulfonamide but has typical loop activity and some uricosuric action loop diuretic
Reduces reabsorption of HCO3- in the kidney causing self limited diuresis
Used for hypertension, mild heart failure, nephrolithiasis, nephrogenic diabetes insipidus
Toxicity: Nausea, vomiting, headache. May enhance congestive heart failure or cause pulmonary edema.
Toxicity: Hyperkalemic metabolic acidosis
Only parenteral thiazide available
Pharmacologic antagonist of aldosterone
Toxicity: Infusion site reactions
Toxicity: Hyperkalemia, gynecomastia
MOA: Blocks epithelial sodium channels in collecting tubules
Toxicities: Hypokalemic metabolic alkalosis, hyperuricemia, hyperglycemia, hyponatremia
Antagonist at V1a and V2 ADH receptors. Reduces water reabsorption and increases plasma Na concentration
MOA: Inhibition of NaCl transporter in the distal convoluted tubule
Inhibition of Na/K/Cl transporter in the ascending limb of Henle's loop
Toxicities: Ototoxicity, hypovolemia, K wasting, hyperuricemia, hypomagnesemia
Used for peripheral edema, hypertension, acute hypercalcemia, hyperkalemia, acute renal failure, anion overdose
Mechanism like amiloride, much less potent, more toxic
Toxicities: metabolic acidosis, renal stones, hyperammonemia in cirrhotics
Like spironolactone, more selective for aldosterone receptor

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Created Feb 12, 2011ReportNominate
Tags:agent, diuretic