Diuretic Agents

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Can you name the Diuretic Agents ?

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

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