CLASS DRUGS MECHANISM OF THERAPEUTIC PHARMAC ADVERSE

NAME ACTIONS ACTIONS OKINETIC EFFECT

Thiazides Chlorothiazides Act on distal convulated Hypertension Orally Hypokalemia
(Low Hydrochlorothi tubules (Chlorthalidone effective (60-
ceiling azide Block the Na/Cl ion co- preferred due to 70%) Hypovolemia
Agent) transporter prolong half life
Thiazides like Decrease the reabsorption Half life (10- Hypomagnesem
diuretics: of Na and Cl. Heart failure 15h) ia
(Metolazone)
Chlorthalidone Excreted out in Hyperglycemia
Indapamide Calcium oxalate urine.
Metolazone Stones Hyponatremia
Indapamide
Diabetes insipidus excreted in bile Hypercalcemia
and feces
hyperuricemia

Loop Bumetanide  Act on Ascending Drug of choice for Oral and Iv Hypovolemia
Diuretics Furosemide loop of Henle Peripheral Edema Shock
(Highest (Commonly  Inhibit Na/K/2Cl ,Pulmonary Edema Oral Hypotension
efficacy) Used) co- transporter caused by heart bioavailabilty Cardaic
Torsemide  Increase the failure. 10-90% Arrthymias
Ethacrynic Acid excretion of this Hypokalemia
(infrequently ion in urine. Hypecalcemia Half life 6 hour Hypomagnesem
used due to its  It cause ia
adverse effect diursesis,Venodilat Hyperkalemia Loop diuretics Ototoxicity with
profile) ion,Increase must be intravenous
urinary calcium excreted in route(at faster
excretion tubular lumen rate ,at high
at proximal dose)
convulated Hyperurecemia
tubules. Loop+NSAIDs
= decrease
efficacy
Pottasium 1.Aldosterone  Act on Collecting Most effective Well absorbed Hyperkalemia
Sparing Antagonist duct. diuretic at high dose after oral
Diuretics Spironolactone  Aldosterone for edema associated administration Gynecomastia
(Also bind to Antagonist are with hepatic cirrhosis Most commonly
androgen and synthetic steroids and Nephrotic Undergo the occur with
progesterone that block the syndrome. hepatic spironolactone
receptor aldosterone metabolism to
receptor Hypokalemia active Menstrual
Eplerenone  Block the metabolites Irregularities
translocation of
receptor to nuceus
 (Most selective  Thus inhibit the Resistant Eplerenone is
for Aldosterone intracellular Hypertension metabolized by
Receptor) proteins synthesis Cytochrome
that stimulate the P450 3A4
Na+/k+ pump Heart failue
 Thus decrease
absorption of
sodium and cause Off label used for
retention of PCOS
potassium.

2.Epithelial
sodium
channel
blockers
( less
efficacious )
Amiloride
Trimterene

Carbonic Acetazolamide  Block the Open Angle Orally or Iv Metabolic

Anhydrase Used for other carbonic Glaucoma Acidosis
Inhibitors pharmacologica anhydrase (It decrease the
(Less l effect than for enzymes. production of Hypokalemia
efficacious) diuretic effect. aqueous humor thus
 Carbonic decrease the IOP by 90% Protein Renal stone
Topical: anhydrase inhibiting the CA bounded Formation
Dorzolamide enzyme enzyme in ciliary
Brinzolamide present in body of eyes. Drowsiness
lumen
membrane or Undergo the Paresthesia
cytoplasm of Altitude Sickness active or
tubular cell. Passive Should be
 This enzyme tubular avoided in
catalyze the Prevent the weekness secretions patient with
reaction breathlessness, hepatic cirrhosis
between water naseau, cerebral and as it decrease
and CO2 to pulmonary edema the excretion of
form H2CO3. NH4+.
 H2CO3 ionize
to form H+ and
HCO3-.
 By inhibiting
this enzymes,
 HCO3- ion
retained in the
lumen result in
elevation of
urinary PH and
metabolic
acidosis.

Osmotic Mannitol  Act on descending Used in patient with Not absorbed Dehydration
Diuretics limb of loop of increase intracranial orally
Henle pressure. Extracellular
 Decrease the water Given water expansion
reabsorption with Used to maintain intravenously
little Na excretion. the urine flow
following acute
ingestion of
substances that are
capable of causing
the renal failure.

Not useful for

condition in which
sodium retention
occur