POTASSIUM SPARING

D I U R E T I C S
 POTASSIUM SPARING DIURETICS

 SPIRONOLACTONE.

 AMILORIDE.

 TRIAMTERENE
POTASSIUM SPARING DIURETICS
 PRINCIPAL CELLS 
 Principal Cells  Principal cells are the main
Na+ reabsorbing cells
 
 Site of action of Aldosterone, K+-sparing
diuretics, and spironolactone.

 
 Principal cells secrete K+ through an apical
membrane potassium channel.
 ALDOSTERONE
 Aldosterone affects the body's ability to
regulate blood pressure.

 It sends the signal to organs, like the kidney

and colon
 That can increase the amount of sodium the
body sends into the bloodstream or the amount
of potassium released in the urine.
 Potassium sparing diuretics
TRIAMTERENE & AMILORIDE

 Organic bases.

 Secreted into lumen by proximal tubule cells.

 Inhibit apical Na+ channel

 Potassium sparing diuretics
TRIAMTERENE & AMILORIDE

MODE OF ACTION

 They directly interfere with Na+ entry through the

sodium-selective ion channels on collecting tubules.

 They inhibit potassium secretion and excretion.

MOA
 AMILORIDE TRIAMTERENE
1-These drugs directly block the sodium channels at luminal side of
nephron cells

2-Because of sodium channel blockage No entry of sodium into the

cell.

3-When there is no entry of sodium in the cell it cause no release of

potassium from the cell.(k sparing)

4-Sodium blockage will cause luminal cell less ecteronegativity

this will also cause less entry of k into luminal cells
 Potassium sparing diuretics
TRIAMTERENE & AMILORIDE
 Potassium Sparing Diuretics
S P I R O N O LAC T O N E
 Spiranolactone is a synthetic Steroid

 Slow onset and requires several days

 Potassium Sparing Diuretics
S P I R O N O LAC T O N E

MODE OF ACTIONS
 Acts as competitive antagonist to Aldosterone

( Aldosterone receptors )
 Reduce Na+ reabsorption in the collecting
tubules,
 Work of aldo at collecting tubules cells
 Aldosterone has effect on both sides of principle cell of
collecting tubules Luminal as well Basoletral side.
Luminal side
 It activates the inactivated luminal sodium channels

 It develop more sodium channels at luminal side

 it increases the frequency of sodium channels reabosrptions

Vasoletral side
 it super activate the N/k Atpases

 It develop more N/K Atpases

Aldo overall influence the sodium reabosrption and potassium loss

MOA
 S P I R O N O LAC T O N E
1-Analoge of Aldosterone
2-Compitatively block the Aldosterone activity

3-Sodium will not be reabsorbed because of

blockage of aldo-

4-And also will not bring the k into the cell if no k

potassium there will be no loss of k into the
luminal
Potassium Sparing Diuretics
S P I R O N O LAC T O N E
 Potassium Sparing Diuretics
S P I R O N O LAC T O N E

RESULT IN
 Increased sodium loss.

 Increased chloride loss.

 Decreased potassium loss.

 Pharmacokinetics
Spironolactone
 Orally administered
 Aldactazide: spironolactone/thiazide combo
Amiloride
 Oral administration, 50% effective
 Not metabolized
 Not bound to plasma proteins
Triamterine
 Oral administration, 50% effective
 60% bound to plasma proteins
 Liver metabolism, active metabolites
 Potassium Sparing Diuretics

INDICATIONS
 Spironolactone is a weak diuretics so
used with Thiazide or Furosemide for
the Edema
 Cardiac failure

 Nephrotic syndrome
 Potassium Sparing Diuretics
Toxicities
 Hyperkalemia

 Hyperchloremic Metabolic Acidosis

 Renal Failure
 Kidney Stones
 Gynacomastia
Q#1 Name the class of Diuretics that act on this part of the tubule.

Q#2 Name two drugs that block the channel marked with blue arrow.&
name the drug that block the hormone with red arrow.
Q#3 What is the major advantage of this class compared to other
diuretics?
Q#4 Which hormone acts on this part of the tubule?

Q#5 What are the two major side-effects of this drug?