Clinical Pharmacology of Diuretics

DIURETIC DRUGS  diuretics are considered to be substances that aid in removing excess extracellular fluid and electrolytes. In the main, they accomplish this by decreasing salt and water reabsorption in the tubules. The different types of diuretic drugs are  Carbonic anhydrase inhibitors  Loop diuretics  Osmotic diuretics  Potassium-sparing diuretics  Thiazides and related diuretics

DIURETIC DRUGS  Diuretics relieve pulmonary congestion and peripheral edema. These agents are useful in reducing the symptoms of volume overload, including orthopnea and paroxysmal nocturnal dyspnea. Diuretics decrease plasma volume and subsequently decrease venous return to the heart (preload). This decrease the cardiac workload and oxygen demand. Diuretics also decrease afterload by reducing plasma volume, thus decreasing blood pressure.

Indications to use

Thiazide and Related Diuretics

Thiazide Diuretics

Loop Diuretics

 Loop diuretics are the diuretics of choice when rapid effects are required (eg, in pulmonary edema) and when renal function is impaired (creatinine clearance < 30 mL/minute).

Loop Diuretics

Potassium-Sparing Diuretics

Potassium-sparing diuretics

Osmotic diuretics

Digoxin and diuretics  When digoxin and diuretics are given concomitantly, as is common for clients with heart failure, the risk of digoxin toxicity is increased. Digoxin toxicity is related to diureticinduced hypokalemia.