MEDICAMENTOS: DIURETICOS

Manitol

• Class: Osmotic diuretic

• Site of action: Proximal tubule & loop of Henle

• Mechanism: Filtered by glomerulus but not reabsorbed → creates osmotic gradient → water stays in tubule → increased urine

• Effect: Moderate diuresis, usually electrolytes unchanged

• Clinical uses: Cerebral edema, glaucoma, increase urine output in acute kidney injury

• Adverse effects: Nausea, headache, dizziness, chills

• Contraindications: Heart failure with edema, pulmonary edema, intracranial bleeding

List osmotic diuretics

1. glycerin (osmoglyn)

2. isosorbide (ismotic)

3. mannitol (osmitrol)

4. urea (ureaphil)

List Carbonic anhydrase inhibitors

1. Acetazolamide (Diamox)

2. Methazolamide

What are the main clinical uses of acetazolamide?

• Glaucoma

• Edema

• Epilepsy

What is the main clinical use of methazolamide?

Glaucoma

What is the trade name of acetazolamide?

Diamox

Which adverse effect is common to carbonic anhydrase inhibitors?

Dizziness

headache

GI distress

metabolic acidosis

Name two osmotic diuretics used for acute glaucoma attacks.

Glycerin (Osmoglyn) and Isosorbide (Ismotic)

Which osmotic diuretic is used to reduce intracranial pressure and also works for glaucoma?

Mannitol (Osmitrol) and Urea (Ureaphil)

Which osmotic diuretic is used to treat oliguria and remove toxins?

Mannitol (Osmitrol)

What are the type of diuretics?

1. agentes osmoticos

2. carbonic anhydrase inhibitors

3. thiazide and thiazide-like compounds

4. acidos organicos

5. potassium-sparing diureticos

6. antagonistas de ADH

Thiazide diuretics – mechanism, site, and main side effects?

• Mechanism: Block Na⁺/Cl⁻ reabsorption in distal tubule → water follows → ↑ urine

• Site: Distal convoluted tubule

• Side effects: Hypokalemia, hyponatremia, hyperglycemia, muscle cramps, headache, hypotension

List of Organic Acids

1. BUmetanide (Bumex)

2. Ethacrynic acid (Edecrin)

3. Furosemide (Lasix)

4. Torsemide (Demadex)

Furosemide (Lasix)

• Pulmonary edema

• Hypertension

Ethacrynic acid (Edecrin) & Bumetanide (Bumex)

Edema from CHF, renal disease, cirrhosis, nephrotic syndrome; short-term ascites

Torsemide (Demadex)

Edema from CHF, renal disease, cirrhosis

What is the main effect of potassium-sparing diuretics?

Prevent potassium excretion → retain potassium

List of Potassium-sparing diuretics

1. Amiloride (Midamor)

2. Eplerenone (Inspra)

3. Spironolactone (Aldactone)

4. Triamterene (Dyrenium)

Which diuretic commonly causes gynecomastia?

Spironolactone (Aldactone)

What is the main dangerous side effect of potassium-sparing diuretics?

Hyperkalemia.

What hormone regulates water balance in the body?

ADH (Antidiuretic hormone)

What is the mechanism of ADH antagonists?

Block ADH receptors in kidneys → prevent water reabsorption → excrete free water

What is the mechanism of xanthine derivatives as diuretics?

Increase renal blood flow → mild diuresis

What are common effects of xanthine derivatives?

CNS stimulation
Hypotension
Headache