Part 51 Diuretic Agents .

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Classes of Diuretics. Thiazide and thiazide-like diureticsLoop diureticsCarbonic anhydrase inhibitorsPotassium-saving diureticsOsmotic diuretics. Capacity of Diuretic Agents. Build the measure of pee delivered by the kidneysIncrease sodium discharge. Signs for Diuretic Use. Edema connected with congestive heart failureAcute aspiratory edemaLiver illness (counting cirrhosis)Renal infection
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Section 51 Diuretic Agents

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Classes of Diuretics Thiazide and thiazide-like diuretics Loop diuretics Carbonic anhydrase inhibitors Potassium-saving diuretics Osmotic diuretics

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Function of Diuretic Agents I ncrease the measure of pee delivered by the kidneys Increase sodium discharge

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Indications for Diuretic Use Edema connected with congestive heart disappointment Acute pneumonic edema Liver ailment (counting cirrhosis) Renal infection Hypertension Conditions that cause hyperkalemia

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Causes of Edema and Ascites in Patients With Liver Failure Reduced plasma protein generation Results in less oncotic pull in the vascular framework and liquid misfortune at the fine level Obstructed blood move through the gateway framework Caused by expanded weight from congested hepatic vessels

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Thiazide and Thiazide-Like Diuretics Hydrochlorothiazide ( HydroDIURIL ) Chlorothiazide ( Diuril ) Bendroflumethiazide ( Naturetin ) Benzthiazide ( Exna ) Hydroflumethiazide ( Diucardin ) Methyclothiazide ( Aquatensen ) Polythiazide ( Renese ) Trichlormethiazide ( Diurese )

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Sites of Action of Diuretics in the Nephron

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Indications for Thiazide and Thiazide-Like Diuretics Treatment of edema connected with CHF, liver, or renal malady Monotherapy or assistants for the treatment of hypertension

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Focus on the Prototype Thiazide Diuretic: Hydrochlorothiazide Indications: Adjunctive treatment for edema connected with CHG, cirrhosis, corticosteroid and estrogen treatment, and renal brokenness; treatment of hypertension Actions: Inhibits reabsorption of sodium and chloride in distal renal tubules, expanding the discharge of sodium, chloride, and water by the kidneys Oral course: Onset 2 h; top 4–6 h; length 6–12 h T ½ : 5.6–14 h; metabolized in the liver and discharged in pee

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Loop Diuretics Currently Available Furosemide ( Lasix ) Most usually utilized; less effective than new medications; bigger edge of wellbeing for home utilize Bumetanide ( Bumex ) and torsemide ( Demadex ) New medications; more capable than Lasix Ethacrynic corrosive ( Edecrin ) First circle diuretic presented, utilized less much of the time in the clinical setting

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Indications for Loop Diuretics Acute CHF Acute aspiratory Edema connected with CHF Edema connected with renal or liver illness Hypertension

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Focus on the Loop Diuretic Prototype: Furosemide Indications: Treatment of edema connected with CHF, intense pneumonic edema, hypertension Actions: Inhibits reabsorption of sodium and chloride from the proximal and distal renal tubules and the circle of Henle, prompting to a sodium-rich diuresis Oral course: Onset 60 min; crest 60–120 min; term 6–8 h IV, IM course: Onset 5 min; top 30 min; span 2 h T ½ : 120 min; metabolized in the liver and discharged in pee

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Focus on the Carbonic Anhydrase Inhibitors Prototype: Acetazolamide ( Diamox ) Indications: Treatment of glaucoma; edema brought on by CHF, tranquilize initiated edema; centrencephalic epilepsy; prophylaxis and treatment of intense elevation disorder Actions: Inhibits carbonic anhydrase, which diminishes watery silliness arrangement in the eye; intraocular weight and hydrogen emission by the renal tubules Routes: Oral, SR, IV T ½ : 5–6 hr; discharged unaltered in pee

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Potassium-Sparing Diuretics Types Amiloride ( Midamor ) Spironolactone ( Aldactone ) Triamterene ( Dyrenium ) Uses Patients at high hazard for hypokalemia connected with diuretic utilize

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Osmotic Diuretics Types Glycerin ( Osmoglyn ), Isosorbide ( Ismotic ), Mannitol ( Osmitrol ), and Urea ( Ureaphil ) Action Pull water into the renal tubule without sodium misfortune Indications Increased cranial weight or intense renal disappointment because of stun, medication overdose, or injury

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