Diuretics

DIURETICS

1. DIURETICS Presented by: G.T.ROOPESH M.PHARM .,( Ph.D ) Asso.Professor , Dept. of Pharma.Chemistry BCP-ATP.

2. CONTENTS INTRODUCTION TO DIURETICS CLASSIFICATION (GENERAL) LOOP OR HIGH CELING DIURETICS (SITE-2) THIAZIDE DIURETICS (SITE-3) POTASSIUM-SPARING DIURETICS (SITE-4) CARBONIC ANHYDRASE INHIBITORS (SITE -1) CALCIUM-SPARING DIURETICS OSMOTIC DIURETICS ( Mannitol ) SITES OF NEPHRON (SITE-1,2,3,4) DIURETICS SITE:1 CARBONIC ANHYDRASE INHIBITORS (ACETAZOLAMIDE) SITE:2 LOOP DIURETICS SYNTHESIS OF FUROSEMIDE, ETHACRYNIC ACID, SAR. SITE:3 THAIZIDE DIURETICS SYNTHESIS OF HYDROCHLOR THIAZIDE,SAR SITE: 4 POTASSIUM-SPARING DIURETICS Spironolactone , Amiloride , Triamterene . Uses & side effects of Diuretics

3. INTRODUCTION TYPES OF DIURETICS 1.MERCURIALS 2.NON-MERCURAL DIURETICS

4. 3.OTHER DIURETICS Classification

5. MERALLURIDE

6. FUROSEMIDE ETHACRYNIC ACID

7. Adverse effects (FUROSEMIDE) Furosemide also can lead to  gout  caused by  hyperuricemia .  Hyperglycemia  is also a common side effect. The tendency, as for all loop diuretics, to cause low serum potassium concentration ( hypokalemia ) has given rise to combination products, either with potassium or with the  potassium-sparing diuretic   amiloride  ( Co- amilofruse ). Other electrolyte abnormalities that can result from furosemide use include hyponatremia , hypochloremia , hypomagnesemia , and hypocalcemia . In the treatment of heart failure, many studies have shown that the long-term use of furosemide can cause varying degrees of  thiamine deficiency , so  thiamine  supplementation is also suggested. Although disputed, it is considered  ototoxic : "usually with large intravenous doses and rapid administration and in renal impairment". Other precautions include: nephrotoxicity , sulfonamide (sulfa) allergy, and increases free thyroid hormone effects with large doses.

8. THIAZIDE DIURETICS

9. POTASSIUM-SPARING DIURETICS

10. CARBONIC ANHYDRASE INHIBITORS EX: ACETAZOLAMIDE, METHAZOLAMIDE

11. CALCIUM SPARING DIURETICS

12. OSMOTIC DIURETICS MOA OF OSMOTIC DIURETICS

13. OSMOTIC DIURETICS

14. SAR OF CARBONIC ANHYDRASE INHIBITORS

15. SYNTHESIS OF FUROSEMIDE (FRUSEMIDE) (OR)

16. SYNTHESIS OF ETHACRYNIC ACID USES OF ETHACRYNIC ACID

17. SAR OF LOOP DIURETICS 5-SulfamoylBenzoic acid derivatives--- Ex: Furosemide , Bumetanide etc.,

18. SAR OF HYDROTHIAZIDES (THIAZIDE DIURETICS)

19. SAR OF HYDROTHIAZIDES (THIAZIDE DIURETICS ) Continued

20. SYNTHESIS OF HYDROCHLORTHIAZIDE

21. MEDICINAL USES OF DIURETICS

22. TRIAMTERENE

23. ALDOSTERONE ANTAGONISTS MOA OF SPIRONOLACTONE METABOLISM OF SPIRONOLACTONE