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Diuretic drugs
1. DIURETIC DRUGS
Clarise Elefante
Shirley Garay
Daniel Alexei Garcia
2. Diuretic Drugs
• Medications that augments “Diuresis”
• Commonly known as Water Pills
• Homeopathic remedies or foods that
help to prevent or treat fluid retention
• Used to treat heart failure, liver
cirrhosis, hypertension and
certain kidney diseases.
3. Diuresis
• Process involved in the
administration of the drugs
• Condition in which body
loses water through excess
urination
• Leads advantage and
disadvantage of taking
diuretic drugs.
4. Why the need to lose fluids?
• Failure to excrete excess fluid from the body.
• If there are renal, cardiovascular, or
metabolic disorders
• Congestive Heart Failure Patients- reduction
of fluid in blood, reduces pressure on the
heart, so that its efficiency of pumping blood
is increased.
5. Why the need to lose fluids?
• Hypertensive Patients- the loss of sodium,
chlorine and water which helps in lowering of
blood pressure.
• To ease the discomfort of patients suffering
from edema
• Get rid of the body’s excess salts
• May reduce blood volume.
6. Side Effects
• Frequent urination • Blurred vision
• Dehydration • Unusual bleeding or
• Severe potassium bruising
deficiencies • Loss of appetite
• Electrolyte imbalance • Weight loss
• Extreme weakness • May induce breast
• Fatigue enlargement in men
(Pot. Sparing Diuretics)
7. Mechanism of action
• Most diuretics produce diuresis by
inhibiting the reabsorption of sodium at
different segments of the renal tubular
system
• This is accomplished by altering how the
kidney handles sodium.
• If the kidney excretes more sodium, then
water excretion will also increase
8. • passes into glomerular capillaries
located within the cortex (outer zone
of the kidney)
• 20% of the plasma that enters the
glomerular capillaries is filtered
• 65-70% of the filtered sodium is
removed from the urine found within
the proximal convoluting tubule (PCT)
• thick ascending limb has a cotransport
system that reabsorbs sodium,
potassium and chloride at a ratio of
1:1:2
• more sodium is reabsorbed and more
potassium and hydrogen ion are
excreted
• water is reabsorbed in the collected
duct through special pores
• sodium originally filtered is reabsorbed
by the kidney, so that less than 1% of
originally filtered sodium remains in
the final urine.
10. Osmotic Diuretics
• Helps to prevent the reabsorption of
water and sodium in the body
• Increase the amount of blood
flowing into the kidneys
• Prevent the urine to get
concentrated
• Used during heart problems
12. • used to treat patients with oliguric renal
failure
• increases water and sodium excretion,
thereby decreasing extracellular fluid volume
• used clinically in osmotherapy to reduce
acutely raised intracranial pressure
• first drug of choice for the treatment of
acute glaucoma in veterinary medicine
14. Ammonium Chloride
- used as a mild diuretic,
an expectorant, a weight-
reducing agent and a
urine acidifying Azanium chloride
agent.
- combination: used to
control a cough
associated with a cold or
other respiratory illnesses
15. Brand Name Manufacturer
Summer’s Eve Feminine Blooming Fields
Powder, Feminine Wash,
Feminine Bath and
Feminine Cleansing Cloth
16. Carbonic Anhydrase Inhibitor
• decrease bicarbonate (HCO3-) reabsorption in
the proximal tubule by decreasing the amount
of H+ secreted into the lumen.
• inhibitors are established as hypotensive
agents, diuretics and antiepileptics, with
additional use in the management of gastric
and duodenal ulcers, neurological disorders
and osteoporosis.
18. • used to treat glaucoma
• used with other medicines to reduce edema (excess
water retention) and to help control seizures in
certain types of epilepsy
• also used to reduce the severity and duration of
symptoms
Brand names Manufacturer
Cetamid Sea Pharmacom
Zolmide Vista Pharma (Dist.)
19. Benzothiazide
• Frequently are first line drugs for treating mild to
moderate hypertension
• Mainly inhibit reabsorption of Na+ and Cl- via action at
the Na+-Cl- symporter
• Used extensively to treat edema associated with
congestive heart failure (CHF) and cirrhosis of the liver.
• Very often combined with other antihypertensive
agents
• Usually given orally
• Most thiazides are excreted unchanged.
21. Structure Activity Relationship
• C-7 MUST have an unsubstituted sulfonamide and it must be
directly attached to the aromatic ring
• N-2 can be substituted with a small alkyl group
• C-6 electron withdrawing group here increases activity
electron donating groups at C-6 will cause a decrease in
activity (Most clinically-used thiazides have a Cl at C-6 and a
few have a CF3
• 3,4-dihydro derivatives (hydrothiazides) this reduction usually
results in a ~10x increase in potency compared to the oxidized
thiazide ring
• The lipophilicity of the C-3 substituent governs potency and
duration
23. • used to treat high blood pressure
• can lessen symptoms such as shortness of breath or swelling in
your ankles and feet.
• Weakness, dizziness, or a spinning sensation
• Increased blood sugar (hyperglycemia)
Brand Names Manufacturer
Blopress Plus Zuellig
CoAprovel Metro Drug
Combizar United Lab
Hytaz United Lab
Hytzaar Zuellig
Micardis Plus Metro Drug
Pritor Plus Zuellig
25. • used to treat fluid retention (edema) that is caused by
congestive heart failure, severe liver disease (cirrhosis),
kidney disease, or from treatment with a steroid or hormone
medicine.
• also used alone or together with other medicines to treat
high blood pressure (hypertension)
Brand Names Manufacturer
Diuril Lundbeck Inc.
26. LOOP DIURETICS
A T Y P E O F
D I U R E T I C T H AT A C T S
IN THE LOOP OF
HENLE.
M O S T L Y U S E D F O R
HYPERTENSION AND
EDEMA.
M A I N F U N C T I O N S :
INHIBITION OF NKCC2
AND NKCC1
27. Loop
I. Anthranilic Acid derivative with Sulfanilamide
Substance
- Furosemide
- Bumetanide
II. Potassium Sparing Diuretics
- Ethacrynic Acid
29. FUROSEMIDE
Also known as frusemide
Most popular brand is Lasix® by Sanofi-Aventis
Banned by the World’s Anti-doping Agency in sports
due to being a masking agent.
It has also been used to
prevent Thoroughbred and Standard bred race horses
from bleeding through the nose during races.
30. MECHANISM OF ACTION
• It acts by inhibiting NKCC2,
the luminal Na-K-2Cl
symporter in the thick
ascending limb of the loop of
Henle
31. USES:
For the treatment of:
• Edema associated with heart failure,
hepatic cirrhosis, renal impairment, nephrotic syndrome
• Hypertension
• Adjunct in cerebral/pulmonary edema where
rapid diuresis is required (IV injection)
ADVERSE EFFECTS:
• Ototoxicity
• Gout
• Hypokalemia
• In large amounts, dehydration
• Sulfa allergy
39. ETHACRYNIC ACID
• - Etacrynic acid is a phenoxyacetic acid derivative
containing a ketone and a methylene group
• - Known under the tradename Edecrin™
• - Not a sulfonamide
40. USES:
For the treatment of:
• Edema associated with heart failure, hepatic cirrhosis, renal
• impairment, nephrotic syndrome
• Hypertension
• Potent inhibitors of glutathione S-transferase family members
ADVERSE EFFECTS:
• Ototoxicity
• Hypokalemia
• In large amounts, dehydration
• Diarrhea
• In high doses, causes intestinal bleeding
