Diuretics (Saluretics) - 2 | Michigan State University

University:
Michigan State University
Course:
PHM 430 | Human Pharmacology
Academic year:

2022
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341

Pages:

19
Author:

esfredint7qo

Diuretics (Saluretics)-2 High ceiling, loop, high efficacy diuretics: Furosemide (Frusemide) O; I.V Bumetanide O; I.V Ethacrynic acid (prodrug) O; I.V Torsemide (active metabolites) O; I.V The strongest diuretics, have rapid OOA and short DOA Site of action Thick segment of ascending loop of Henle Clinical uses to potassium sparing diuretics: - Hypertension -CHF - Hyperaldosteronism (1° or 2°) - Hypokalemia - Hirsutism (antiandrogenic effect) Side effects to potassium sparing diuretics: Hyperkalemia → cardiac arrhythmias More common in patients with diabetes, chronic renal disease or patients on ACE inhibitors More severe with eplerenone - Gynecomastia in ♂'s (rare with Eplerenone) -Breast tenderness in 's (rare with Eplerenone) b. None steroidal potassium sparing diuretics: Amiloride; Triamterene Site of action: DCT, collecting duct MOA Blockade of epithelial Na+ channels reabsorption, ↓ K+ excretion ↓Na+ Orally effective and available alone or combined with thiazides Clinical uses: - Hypertension - Hypokalemia Side effects: - Hyperkalemia -Renal tubular damage especially reported following the use of Triamterene + Hydrochlorothiazide The problem of diuretic-induced hypokalemia: -Thiazide or loop diuretic + oral K+ supplement -Combine thiazide or loop diuretic with a K+ sparing diuretic ** Unlike thiazide diuretics, loop and K+ sparing diuretics have no effects on blood lipids Reasons for diuretic resistance or refractoriness (Therapeutic Failure): -Continued ingestion of salt - Impairment of organic acid secretion mechanisms in the proximal tubules due to: diseases or drugs - Secondary hyperaldosteronism Cont. diuretic therapeutic failure... - Lowered renal blood flow Na+ reabsorption (postdiuretic salt retention) - Lowered bioavailability of the drug Management of diuretic resistance Restriction of sodium intake, changes in dose, changes in timing, and combination of diuretic therapy

Diuretics (Saluretics) - 2

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