DIURETICS

THIAZIDES - Bendoflumethiazide (Bendrofluazide) *****

 
 Reduce Na reabsorbtion in the distal tubule*. Also increase K loss

 Increased Mg loss but decreased Ca loss

 Induce hyperglycaemia and may exacerbate pre-existing diabetes mellitus

 Produce anti-hypertensive effect which is not secondary to diuresis but

probably due to vasodilation

LOOP DIURETICS - Furosemide (Frusemide), Bumetanide *****

 Rapid onset and short duration of action, cause marked diuresis

 Protein-bound

 Site of action - ascending limb of the loop of Henle *

 Cause loss of Na, Cl as well as K, Ca and Mg

POTASSIUM-SPARING DIURETICS*****

Amiloride, Triamterene, Spironolactone 

 Amiloride & triamterene* - decreases K secretion in the collecting ducts

 Spironolactone *- aldosterone antagonist - inhibits Na reabsorbtion and K

secretion in the distal tubule. Also androgen antagonist may cause
gynaecomastia

 These diuretics may cause hyperkalaemia

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  Acetazolamide is a carbonic anhydrase inhibitor which results in bicarbonate
loss and can cause metabolic acidosis while

All diuretics (apart from the potassium sparing diuretics) may cause hypokalaemia
and precipitate digoxin toxicity 

Mannitol * is an osmotic diuretic and may be used following retention of hypotonic

fluid, for instance in hyponatraemia following trans-cervical resection of
endometrium