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Diuretics
Diuretics
DIURETICS
Diuretics are used primarily to achieve specific therapeutic goals connected to the
management of various medical diseases, particularly those affecting fluid
balance and blood pressure regulation.
2. Loop Diuretics
The loop diuretics (furosemide, torsemide, bumetanide, and ethacrynic acid) act
promptly by blocking sodium and chloride reabsorption in the kidneys, even in
patients with poor renal function or those who have not responded to thiazide
diuretics. Loop diuretics reduce renal vascular resistance while increasing renal
blood flow.
Mode of Action: Loop diuretics work on the thick ascending loop of Henle
in the kidneys to inhibit sodium and water reabsorption. They have a more
potent diuretic effect compared to thiazide diuretics.
3. Potassium-Sparing Diuretics
Amiloride and triamterene (inhibitors
of epithelial sodium transport at the late distal and collecting ducts) as
well as spironolactone and eplerenone (aldosterone receptor antagonists)
reduce potassium loss in the urine. Drugs that block aldosterone have the
added benefit of reducing the heart's occurrence of cardiac remodeling
Failure.
Mode of Action: Potassium-sparing diuretics work by blocking the action of
aldosterone, a hormone that promotes sodium retention and potassium
excretion. This results in increased sodium excretion and potassium
retention.
Dosing Regimen: Typically taken orally.
Adverse Effects: Possible side effects include hyperkalemia (high potassium
levels), gynecomastia (enlargement of breast tissue in males), and
menstrual irregularities in females.
Interactions: Potassium-sparing diuretics should be used cautiously with
other medications that can increase potassium levels, such as ACE
inhibitors, ARBs, and certain supplements.
References:
Finkel, Richard, et al. Lippincott’s Illustrated Reviews : Pharmacology.
Philadelphia Etc., Lippincott Williams & Wilkins, Cop, 2009.
Mayoclinic.org, 2023,
www.mayoclinic.org/drugs-supplements/hydrochlorothiazide-oral-route/
description/drg-20071549. Accessed 3 Oct. 2023.