DIURETICS
Categorised based on mechanism of action on kidney
A Osmotic diuretics carbonic anhydrase inhibitors PCT
B Loop diuretics loop of Henle
c Thiazide thiazide like diuretics
Early DCT
D Potassium sparing diuretics Late DCT t collecting duct
A Osmotic diuretics Mannitol
filtered
Freely parts of
acts on
the nephron most H2O permeable
PCT t early loop of Henle
Reduced H2O reabsorption H 20
retained in filtrate due to osmosis
Reduced electrolyte reabsorption
leak back into tubule down conc gradient
Infused l V for 9 intracranial
mainly pressure
cerebral oedema t intraocular pressure
Side effects Hypotension Fluid electrolyte disturbance
, Carbonic anhydrase inhibitor Acetazolamide
Inhibits carbonic anhydrase in PCT C inter converts
C 021 H2O and H HC05 controls acid base
Reduces Nat and TICO3 reabsorb ti on
Weak diuretic compensated by Nat reabsorption in DCT
Clinical indications Glaucoma t acute altitude
sickness Chyperventilation T CO2 T HC 05 secretion
by kidneys
Adverse effects Metabolic acidosis hypokalaemia
Renal stone formation C due to alkali ire urine
B Loop diuretics Furosemide bumetanide torasemide
Preferably given orally or I V
9 Si bound to proteins in plasma limiting glomerular
filtration
Secreted into tubular lumen by PCT cells via organic
anion transporters COAT
Mode of action Inhibit Nat 1kt ICItransporter in
ascending limb in
loop of henle impermeable to H2O
tr osmolarityof
medullary interstitum lead to
H2O reabsorption from collecting duct
A Renal prostaglandin vasodilation T urine
Categorised based on mechanism of action on kidney
A Osmotic diuretics carbonic anhydrase inhibitors PCT
B Loop diuretics loop of Henle
c Thiazide thiazide like diuretics
Early DCT
D Potassium sparing diuretics Late DCT t collecting duct
A Osmotic diuretics Mannitol
filtered
Freely parts of
acts on
the nephron most H2O permeable
PCT t early loop of Henle
Reduced H2O reabsorption H 20
retained in filtrate due to osmosis
Reduced electrolyte reabsorption
leak back into tubule down conc gradient
Infused l V for 9 intracranial
mainly pressure
cerebral oedema t intraocular pressure
Side effects Hypotension Fluid electrolyte disturbance
, Carbonic anhydrase inhibitor Acetazolamide
Inhibits carbonic anhydrase in PCT C inter converts
C 021 H2O and H HC05 controls acid base
Reduces Nat and TICO3 reabsorb ti on
Weak diuretic compensated by Nat reabsorption in DCT
Clinical indications Glaucoma t acute altitude
sickness Chyperventilation T CO2 T HC 05 secretion
by kidneys
Adverse effects Metabolic acidosis hypokalaemia
Renal stone formation C due to alkali ire urine
B Loop diuretics Furosemide bumetanide torasemide
Preferably given orally or I V
9 Si bound to proteins in plasma limiting glomerular
filtration
Secreted into tubular lumen by PCT cells via organic
anion transporters COAT
Mode of action Inhibit Nat 1kt ICItransporter in
ascending limb in
loop of henle impermeable to H2O
tr osmolarityof
medullary interstitum lead to
H2O reabsorption from collecting duct
A Renal prostaglandin vasodilation T urine
