Diuretic Classification Use Side Effects

Diuretic drug

Diuretic are define as drug causing loss of water and fluid from the body. It is typically use in swelling, edema and oliguria/decreased kidney output.

Diuretics are classified based upon site of action and mechanism of action, there are four types of diuretics, 

• Osmotic diuretics 
• Thiazide diuretics 
• Loop diuretics 
• Potassium sparing diuretics 

Osmotic diuretics 

Osmotic diuretics increase amount of filtrable substance in body which increase filtration and urine production. Osmotic diuretics are filtered by glomerulus and further increase osmosis in nephron tube to carrying filtration process.

Ex. Mannitol, sodium chloride is physiological diuretic

Osmotic diuretics use in,

• Prophylaxis treatment of renal failure 

It is used when kidney is not functioning properly. It help kidney to filter blood and inhibit oliguria.

• Head injury 

In this, osmotic diuretics maintain water balance in the body. It also prevent patient from go into shock.

• Acute oliguria 

Patient with acute oliguria is managed by osmotic diuretics.

Side effects of osmotic diuretics

• Hyperglycemia 

Sudden increase in body metabolism and action lead to increase sugar level in body. It lead to hyperglycemia.

• Electrolyte imbalance 

Electrolyte imbamalance occur when extra fluid is administerd to patient.

• Headache 

Headach is seen due to elevated fluid pressure in body. It can also arise due to cerebral dehydration.

• Hypersensitivity reaction 

Osmotic diuretic can cause hypersensitivity to patient who has severe kidney or heart disorders

Thiazide diuretics 

Thiazide diuretics comprize of, 

• Benzathaizide 
• Chlorothiazide 
• Hydrochlorothiazide 
• Polythiazide 
• Metolazone 

Thiazides diuretics cause loss of sodium, potassium and chloride from the body. 

Thiazide diuretics interfare with reabsorption of salt and water by inhibiting sodium chloride pump. It increase loss of salt and water via nephron. While more sodium in nephron cause exchange of potassium lead to increased potassium excretion.

Thiazides are use in,

• Mild cardiac failure 

Thiazide help in decreasing cardiac after load and pre load by decreasing blood pressure. It cause excretion of fluid and maitain heart function.

• Hypertension 

During hypertension, thaizide help to lowered blood pressure by decreasing fluid volume.

• Nephrotic syndrome 

Nephrotic syndrome is condition characterized by proteinuria, edema and oliguria. Thiazides help to improve urine output, sodium excretion decreases edema in body. 

• Premenstrual tension 

Thiazides are useful in reducing premenstrual tension.

Side Effects 

• Electrolyte imbalance 

Due to loss of sodium, potassium and water substances there is high chance of electrolyte imbalance. 

• Hypokalemia 

Hypokalemia is referred as decreased potassium quantity from the blood.

Loop diuretics 

Loop diuretic are powerful diuretic agent also called as high ceiling diuretics. Loop diuretics inhibit sodium chloride pump completely. It further lead to loose high water from urine. It is powerful than thaizide diuretics. 

It has very high speed of action, efficiency and effectiveness is high. 

Examples:- 

• Furosemide 
• Bumetamide 
• Ethacrynic acid 
• Torsemide 

Loop diuretics were use in, 

• Renal failure 

In reanl failure loop diuretics help in managing urine output and basic function of kidney.

• Edema over heart and kidney 

Loop diuretics use in edema over heart or kidney.

• Cerebral edema 

To decrease edema on cerebral area and decrease fluid loop diuretics were used. 

• High blood pressure 

To lowered blood pressure and maintain normal bp, loop diuretics were use in high blood pressure.

Potassium sparing diuretics 

Potassium spearing diuretics act by increasing sodium and water loss and preventing potassium excretion.

It act on distal convoluted tubule and inhibit sodium potassium ATP pump which exchange sodium for potassium in excretion. It lead to retain potassium in the body.

Ex. Spirono lactone 

Triameterene 

Amiloride 

Potassium sparing diuretics is used in,

• Hypokalemia 

Hypokalemia (low potassium in body) is used when to store potassium and causing fluid loss.

• Edema 

To decreass edema over body organs potassium sparing diuretics are used.

• Ascites caused by liver failure

In ascites, potassium sparing diuretics are used to decrease fluid accumulation in abdomen and decrease abdominal swelling.

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