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DIURETICS How do they work? WHAT DO THEY DO? When do I use them? How do I use them?
Na-K-2Cl SYMPORT INHIBITORS ,[object Object],[object Object],[object Object],Ethacrynic Acid Torsemide Bumetanide 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 ,[object Object],[object Object],[object Object],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 Impotence Increased LDL
Na CHANNEL INHIBITORS ,[object Object],[object Object],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 Hyperkalemia Amiloride Triamterene
MINERALOCORTICOID RECEPTOR ANTAGONISTS ,[object Object],[object Object],[object Object],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

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DIURETICS Part II - What Do They Do

  • 1. DIURETICS How do they work? WHAT DO THEY DO? When do I use them? How do I use them?
  • 2.
  • 3. 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
  • 4. ADVERSE EFFECTS Hypomagnesemia Metabolic Alkalosis Hypokalemia Profound ECFV Depletion Hyperglycemia Hyperuricemia Ototoxicity Hypocalcemia
  • 5. OTHER EFFECTS Increase & Redistribute RBF Increase Renin Release Release PGs Block TGF
  • 6.
  • 7. 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
  • 8. ADVERSE EFFECTS Hypomagnesemia Metabolic Alkalosis Hypokalemia ECFV Depletion Hyperglycemia Hyperuricemia Hyponatremia Hypercalcemia Impotence Increased LDL
  • 9.
  • 10. 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
  • 11. ADVERSE EFFECTS Renal Stones Interstitial Nephritis Megaloblastosis Hyperkalemia Hyperkalemia Amiloride Triamterene
  • 12.
  • 13. 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
  • 14. ADVERSE EFFECTS Impotence Gynecomastia Metabolic Acidosis Hyperkalemia Hirsutism CNS Side Effects Peptic Ulcers Gastritis Menstrual Irregularities Deepening of Voice