Diuresis
Inhibition of active chloride ion reabsorption in PCT and ascending limb of LoH
↓ reabsorption of NaCl → ↓ tonicity in the renal medulla → ↓water reabsorption and diuresis.
Other effects are mediated by the induction of the COX-2 enzyme which assists in synthesis of prostaglandins.

inhibit Na+ reabsorption in the early portion of the distal tubule by
blocking the Na+.Cl- symporter in the apical membrane of these cells. Naturesis
occurs with thiazide diuretics is 5-10% of the filtered load

Pulmonary and systemic vasodilation
Diuresis ↑ RBF and ↑ corticomedullary blood flow
↓O₂ demand in the LoH (ischaemic
protection)

Anti-HTN: (↓TPR, ↓plasma volume)
↓RBF → ↓GFR
↓K+,Na+,Mg.
Hyperchloremic MA
↑Ca++ (↓excretion)
↑Glu: (↓glycogenolysis, ↓insulin)

PO/IV/SL/IM. PO BA 50% Onset PO/SL 30-60mins, IV 5 mins .
Dur PO/SL 6-8hrs, IV 2hrs

PO- BA ~50-80%. Onset 2hrs Dur 6-12hrs.

91-99% (Albumin)

68%

0.1L/kg

3.6-7.8L/kg

Renal to glucuronide
Minimal hepatic

Not metabolized

80% unchanged in urine

Urine (unchanged)

0.5-2hrs. ESRF: 9hrs

5.6-14.8hrs

↓ K+/Na+/Cl-/Ca++, Hyper- urea/glu/chol, Metabolic alkalosis
Tox: Deafness, Pancreatitis
BM depression
Interstitial nephritis (worse with aminoglycoside)

↓K+/Na+/Mg++, ↑Ca++/urea/glu/chol.
indiosyncratic blood
dyscrasias. Rash, photsensitivity. Interactions may prolong action of NDMBs. NSAIDs antagonise the action

Diuretic - Loop

Diuretic - Thiazide

Oedema of cardiac, renal or hepatic origin, Renal insufficency
Hypertension
Raised ICP
Hypercalcaemia

heart failure and hypertension. Used in combination. mostly bound to plasma prot, and gain access to the tubule via secretion in the PCT.

Sulfonamide derivative

related to the sulphonamides

Level 1

Level 3

Photosensitive solution 10mg/ml
20/40/500mg tabs, Syrup

orange scored tablets of 25mg and combos

20-2000mg daily
PO/IV/SL/IM.

PO. 12.5-200mg/day