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Cardiovascular Renal System

Drugs that accelerate the rate of urine formationIn the nephron, where sodium goes, water follows20% to 25% of all sodium is reabsorbed into the bloodstream in the ascending loop of Henle5% to 10% in the distal convoluted tubules3% in collecting ductsIf water is not absorbed, it is excreted as

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Cardiovascular Renal System

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    1. Cardiovascular & Renal System Diuretics Lilley Reading & Workbook, Chap 25

    2. Drugs that accelerate the rate of urine formation In the nephron, where sodium goes, water follows 20% to 25% of all sodium is reabsorbed into the bloodstream in the ascending loop of Henle 5% to 10% in the distal convoluted tubules 3% in collecting ducts If water is not absorbed, it is excreted as urine Result: removal of sodium and water Diuretics

    3. Diuretics

    4. Diuretic Drugs Classifications Carbonic anhydrase inhibitors Loop diuretics Osmotic diuretics Potassium-sparing diuretics Thiazide and thiazide-like diuretics

    5. Diuretics Carbonic Anhydrase Inhibitors (CAI) Mechanism of Action The enzyme carbonic anhydrase helps to make H+ ions available for exchange with sodium and water in the proximal tubules CAIs block the action of carbonic anhydrase, thus preventing the exchange of H+ ions with sodium and water reduces H+ ion concentration in renal tubules Result: increased excretion of bicarbonate, sodium, water, & K+ Resorption of water is decreased and urine volume is increased

    6. Diuretics Carbonic Anhydrase Inhibitors (CAIs) acetazolamide (Diamox) methazolamide dichlorphenamide

    7. Diuretics Carbonic Anhydrase Inhibitors Indications Adjunct drugs in the long-term management of open-angle glaucoma* Used with miotics to lower intraocular pressure before ocular surgery in certain cases Also useful in the treatment of: Edema* Epilepsy High-altitude sickness Acetazolamide (Diamox) is used in the management of edema secondary to HF when other diuretics are not effective* CAIs are less potent diuretics than loop diuretics or thiazides—the metabolic acidosis they induce reduces their diuretic effect in 2-4 days

    8. Diuretics Carbonic Anhydrase Inhibitors: Adverse Effects Metabolic acidosis Anorexia Hematuria Photosensitivity Melena

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