DIURETICS How do they work? WHAT DO THEY DO? When do I use them? How do I use them?

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Presentation transcript:

DIURETICS How do they work? WHAT DO THEY DO? When do I use them? How do I use them?

Na-K-2Cl SYMPORT INHIBITORS Also Called: Loop Diuretics High Ceiling Diuretics Ethacrynic Acid TorsemideBumetanide Furosemide

THERAPEUTIC EFFECTS Increase Na Excretion to 25% of Filtered Load Treatment for Oliguric ARF Increase Ca Excretion Treatment for Hypercalcemia Impair Free Water Reabsorption Treatment for Hyponatremia Increase Venous Capacitance Treatment for Pulmonary Edema Increase Urine Volume Treatment for Severe Edema

ADVERSE EFFECTS Hypomagnesemia Metabolic Alkalosis Hypokalemia Profound ECFV Depletion Hyperglycemia Hyperuricemia Ototoxicity Hypocalcemia

OTHER EFFECTS Increase & Redistribute RBF Increase Renin Release Release PGs Block TGF

Na-Cl SYMPORT INHIBITORS Also Called: Thiazide Diuretics Thiazide-Like Diuretics Chlorthalidone Metolazone Chlorothiazide Hydrochlorothiazide

THERAPEUTIC EFFECTS Increase Na Excretion to 5% of Filtered Load Treatment for Hypertension Decrease Ca Excretion Treatment for Calcium Nephrolithiasis Treatment for Nephrogenic Diabetes Insipidus Treatment for Mild Edema

ADVERSE EFFECTS Hypomagnesemia Metabolic Alkalosis Hypokalemia ECFV Depletion Hyperglycemia Hyperuricemia Hyponatremia Hypercalcemia ImpotenceIncreased LDL

Na CHANNEL INHIBITORS Also Called: K-Sparing Diuretics Amiloride Triamterene

THERAPEUTIC EFFECTS Enhance Natriuresis Caused by Other Diuretics Block Na Channels Treatment for Liddle’s Syndrome Prevent Hypokalemia Used in Combination with Loop & Thiazide Diuretics Treatment for Lithium- Induced Diabetes Insipidus

ADVERSE EFFECTS Renal Stones Interstitial Nephritis Megaloblastosis Hyperkalemia Amiloride Triamterene

MINERALOCORTICOID RECEPTOR ANTAGONISTS Also Called: K-Sparing Diuretics Aldosterone Antagonists Spironolactone Eplerenone

THERAPEUTIC EFFECTS Enhances Natriuresis Caused by Other Diuretics Blocks Aldosterone Treatment for Primary Hyper- aldosteronism Prevents Hypokalemia Used in Combination with Loop & Thiazide Diuretics Treatment for Edema of Liver Cirrhosis Treatment for Hypertension Treatment for Heart Failure

ADVERSE EFFECTS Impotence Gynecomastia Metabolic Acidosis Hyperkalemia Hirsutism CNS Side Effects Peptic Ulcers Gastritis Menstrual Irregularities Deepening of Voice