1 / 15

Chapter 51 Diuretic Agents

Chapter 51 Diuretic Agents. Classes of Diuretics. Thiazide and thiazide-like diuretics Loop diuretics Carbonic anhydrase inhibitors Potassium-sparing diuretics Osmotic diuretics. Function of Diuretic Agents. I ncrease the amount of urine produced by the kidneys Increase sodium excretion.

Albert_Lan
Download Presentation

Chapter 51 Diuretic Agents

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Chapter 51Diuretic Agents

  2. Classes of Diuretics • Thiazide and thiazide-like diuretics • Loop diuretics • Carbonic anhydrase inhibitors • Potassium-sparing diuretics • Osmotic diuretics

  3. Function of Diuretic Agents • Increase the amount of urine produced by the kidneys • Increase sodium excretion

  4. Indications for Diuretic Use • Edema associated with congestive heart failure • Acute pulmonary edema • Liver disease (including cirrhosis) • Renal disease • Hypertension • Conditions that cause hyperkalemia

  5. Causes of Edema and Ascites in Patients With Liver Failure • Reduced plasma protein production • Results in less oncotic pull in the vascular system and fluid loss at the capillary level • Obstructed blood flow through the portal system • Caused by increased pressure from congested hepatic vessels

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

  7. Sites of Action of Diuretics in the Nephron

  8. Indications for Thiazide and Thiazide-Like Diuretics • Treatment of edema associated with CHF, liver, or renal disease • Monotherapy or adjuncts for the treatment of hypertension

  9. Focus on the Prototype Thiazide Diuretic: Hydrochlorothiazide • Indications:Adjunctive therapy for edema associated with CHG, cirrhosis, corticosteroid and estrogen therapy, and renal dysfunction; treatment of hypertension • Actions:Inhibits reabsorption of sodium and chloride in distal renal tubules, increasing the excretion of sodium, chloride, and water by the kidneys • Oral route: Onset 2 h; peak 4–6 h; duration 6–12 h • T½:5.6–14 h; metabolized in the liver and excreted in urine

  10. Loop Diuretics Currently Available • Furosemide (Lasix) • Most commonly used; less powerful than new drugs; larger margin of safety for home use • Bumetanide (Bumex) and torsemide (Demadex) • New drugs; more powerful than Lasix • Ethacrynic acid (Edecrin) • First loop diuretic introduced, used less frequently in the clinical setting

  11. Indications for Loop Diuretics • Acute CHF • Acute pulmonary edema • Edema associated with CHF • Edema associated with renal or liver disease • Hypertension

  12. Focus on the Loop Diuretic Prototype: Furosemide • Indications:Treatment of edema associated with CHF, acute pulmonary edema, hypertension • Actions:Inhibits reabsorption of sodium and chloride from the proximal and distal renal tubules and the loop of Henle, leading to a sodium-rich diuresis • Oral route: Onset 60 min; peak 60–120 min; duration 6–8 h • IV, IM route: Onset 5 min; peak 30 min; duration 2 h • T½:120 min; metabolized in the liver and excreted in urine

  13. Focus on the Carbonic Anhydrase Inhibitors Prototype: Acetazolamide (Diamox) • Indications:Treatment of glaucoma; edema caused by CHF, drug-induced edema; centrencephalic epilepsy; prophylaxis and treatment of acute altitude sickness • Actions:Inhibits carbonic anhydrase, which decreases aqueous humor formation in the eye; intraocular pressure and hydrogen secretion by the renal tubules • Routes: Oral, SR, IV • T½:5–6 hr; excreted unchanged in urine

  14. Potassium-Sparing Diuretics • Types • Amiloride (Midamor) • Spironolactone (Aldactone) • Triamterene (Dyrenium) • Uses • Patients at high risk for hypokalemia associated with diuretic use

  15. Osmotic Diuretics • Types • Glycerin (Osmoglyn), Isosorbide (Ismotic), Mannitol (Osmitrol), and Urea (Ureaphil) • Action • Pull water into the renal tubule without sodium loss • Indications • Increased cranial pressure or acute renal failure due to shock, drug overdose, or trauma

More Related