DIURETICS
DIURETICS
THIAZIDES - Bendoflumethiazide (Bendrofluazide) *****
• Reduce Na reabsorbtion in the distal tubule*. Also increase K loss
• Increased Mg loss but decreased Ca loss
• Induce hyperglycaemia and may exacerbate pre-existing diabetes mellitus
• Produce anti-hypertensive effect which is not secondary to diuresis but probably due to vasodilation
LOOP DIURETICS - Furosemide (Frusemide), Bumetanide *****
• Rapid onset and short duration of action, cause marked diuresis
• Protein-bound
• Site of action - ascending limb of the loop of Henle *
• Cause loss of Na, Cl as well as K, Ca and Mg
POTASSIUM-SPARING DIURETICS*****
Amiloride, Triamterene, Spironolactone
• Amiloride & triamterene* - decreases K secretion in the collecting ducts
• Spironolactone *- aldosterone antagonist - inhibits Na reabsorbtion and K secretion in the distal tubule. Also androgen antagonist may cause gynaecomastia
• These diuretics may cause hyperkalaemia
• Acetazolamide is a carbonic anhydrase inhibitor which results in bicarbonate loss and can cause metabolic acidosis while
All diuretics (apart from the potassium sparing diuretics) may cause hypokalaemia and precipitate digoxin toxicity
Mannitol * is an osmotic diuretic and may be used following retention of hypotonic fluid, for instance in hyponatraemia following trans-cervical resection of endometrium
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