DIURETICS

Diuretics decrease blood pressure

Decrease in plasma volume = Dec. in BP

Four Main Types of Diuretics:

1. Osmotic Diuretics
2. Loop Diuretics
3. Thiazide Diuretics
4. Potassium Sparing Diuretics
*carbonic anhydrase inhibitors

Diuretics aim to decrease blood pressure, less burden

on cardiovascular disease?

Osmotic Diuretics

- PREVENT REABSORPTION of water which will

Golden Rule: Water follows Sodium
Thus, when water and sodium are reabsorbed this will
lead to increased blood pressure
Diuretics prevents the reabsorption of water and
sodium -> decrease blood pressure
reduce plasma volume thus decrease blood
pressure
- Increases excretion of Sodium, Potassium,
Calcium, Magnesium, Chloride, Sodium
Bicarbonate, Hydrogen oxide and Water
- Freely filtered at the glomerulus and enter the
tubules
- They limit the reabsorption of water in the
tubules by increasing the osmolality in the renal
tubule
ABSORPTION AND ELIMINATION
Mannitol and Urea – given IV
Glycerin and Isosorbide – given orally

Thus, elimination has short duration of activity

Osmotic Diuretics

- Act on PROXIMAL CONVOLUTED TUBULES and

LOOP OF HENLE
- Mannitol, Urea, Glycerin, Isosorbide
- They Increase the solute concentration within
the tubules
- Therefore, causes water retention within the
tubules
- Because it follows the OSMOSIS RULE, where
they follow to the higher concentration area
LOOP DIURETICS POTASSIUM SPARING DIURETICS

- Acts on thick ascending limb of Loop of Henle - Acts in distal convoluted tubule and collecting
- Furosemide, Bumetanide ducts
- Acts to decrease the reabsorption of sodium
and prevent the excretion of potassium

Two Types:

1. Amiloride, Triamterene
- Normally, sodium is reabsorbed from the lumen
of nephron
- When transporter reabsorbs sodium, it excretes
potassium to the tubular lumen
- Then, K+sparing diuretics inhibits sodium
reapsorption

THIAZIDE DIURETICS

- Hydrochlorothiazide, Chlorothiazide
- Acts on the Distal Convoluted Tubule
- Inhibit the secretion of Calcium and Promote
2. Spironolactone (Aldosterone Inhibitors)
the secretion of magnesium
- Acts on the collecting ducts
- Within the blood, there is aldosterone secreted
by adrenal gland

CARBONIC ANHYDRASE INHIBITORS

- Acts on proximal convoluted tubules

- They prevent the reabsorption of sodium
bicarbonate so they will cause less sodium to be
reabsorbed so decrease blood pressure
- Weakest diuretics
- Used to Treat Glaucoma