Diuretic Agents

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Can you name the Diuretic Agents ?

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

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