PHARMACOLOGY-FINALS

Diuretics  Considered as a weak diuretic but also has

What are diuretics? vasodilatory effects (FIRST CHOICE IN
 These are classes of drugs that stimulate excretion of HYPERTENSION)
water from the body.  Adverse Effects
 Uses  Electrolyte imbalances
 Management of hypertension  Hyponatremia
 Treatment of fluid retention aka edema  Hypokalemia
 Reduction of intracranial pressure  Hypercalcemia
 Classifications of diuretics  Hyperuricemia → Gout
 Carbonic anhydrase inhibitors  Hyperglycemia
 Loop diuretics  Hyperlipidemia
 Thiazide diuretics d) Potassium-Sparing Diuretics
 K-Sparing diuretics This type of diuretic doesn’t excrete the potassium in the
 Osmotic diuretics body, and it blocks the aldosterone receptors, which are
responsible for fluid retention; blocking them will not
retain the fluid in the body, hence we’ll urinate it.
 Amiloride, Triamterene, Spironolactone
 Acts on Aldosterone Receptors in the collecting
duct
 Considered as a weak diuretic; often used as an
add-on to other diuretics.
Rarely used alone (ex: Thiazide + K-sparring diuretic).
 Adverse Effects
 Electrolyte imbalances
 Hyperkalemia→cardiac arrest
Potassium should not be given as an IV bolus; instead, it
The illustration above shows the nephron, and it indicates
should be given as an IV drip because giving it to the
where the different diuretics act:
circulatory system too quickly may result in cardiac
Carbonic anhydrase inhinitors→proximal convuluted
arrest. 
tubule
Loop diuretics→ascending loop of henle  Menstrual irregularities in females
Thiazide diuretics→distal convuluted tubule  Gynecomastia in males
K-sparring diuretics→collecting duct e) Osmotic Diuretics
Osmotic diuretics- doesn’t act particularly in nephron.  Mannitol
a) Carbonic Anhydrase Inhibitors  Directly stimulates excretion of water rather than
 Acetazolamide excretion of sodium.
 Acts on the Proximal Convoluted Tubule It is the only diuretic that excretes only water because the
 Has very weak diuretic effect other diuretics excrete sodium and water ("where sodium
 Therefore it is preferred for other uses such as goes, water follows").
treatment of glaucoma
 Adverse Effects  Mainly used for
 Malaise  DOC for reduction of intracranial pressure.
 Anorexia  Urination of toxic substances
 Fatigue  Urine production in patients with acute kidney
 Restlessness failure
b) Loop Diuretics Acute kidney failure can cause urinary retention, so an
 Furosemide, Ethacrynic Acid osmotic diuretic can be used to produce urine.
 Acts on the Thick Ascending Loop of Henle =
 Considered as the strongest diuretic  Adverse Effects
 Adverse Effects  Dehydration
 Rapid reduction in blood volume aka
hypovolemia (low blood volume)
 May lead to hypotension, shock, cardiac
arrhythmias
 Electrolyte imbalances
 Hyponatremia
 Hypokalemia
 Hypocalcemia
 Ototoxicity
 Hyperuricemia → Gout
c) Thiazide Diuretics
 Hydrochlorothiazide, Chlorothiazide
Ends in  Acts on the Distal Convoluted Tubule
-thiazide
QUELUSTINA
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