Diuretics : Classification of Diuretics

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1. Diuretics Diuretics are those drug which promote urine formation or outflow of urine . They are also responsible for exrection of sodium , chloride , bicarbonate and water from body. They increase the urine volume . They act by decreasing the tubular reabsorption. Diuretics do not affect either Glomerular filteration rate or action of antidiuretic hormone .

2. Uses of Diuretics They used in the management of hypertension , C.H.F , etc. They are also used in removal of kidney stone and cleaning of UTI. They are mainly used in treatment of edema . Deposition of body fluids .

3. Classification of Diuretics Diuretics Xanthine derivatives Organomercurials Carbonic anhydrase inhibitors Acidifying agent Osmotic diuretics Thiazide diuretics Loop diuretics Potassium sparing agents

4. Xanthine Derivatives R 1 R 2 R 3 Caffeine CH 3 Theophylline Theobromine R 3 R 2 R 1 CH 3 CH 3 CH 3 CH 3 CH 3 CH 3 H H 1 2 3 4 5 6 7 8 9

5. Organomercurials Mercurials are now limited in use because they cause renal and tubular damage and given parenterally. Examples are -: Mercaptomerin sodium Chlormerodrin Chlormerodrin

6. Carbonic Anhydrase Inhibitors Acetazolamide Carbonic anhydrase responsible for reabsorption of ions like sodium etc Carbonic anhydrase inhibitors act by decreasing reabsorption of ions. 1.

7. Carbonic Anhydrase Inhibitors Methazolamide 2.

8. Acidifying Agents Ammonium chloride Calcium chloride

9. Osmotic Diuretics Mannitol Osmotic diuretics decrease osmotic pressure hence decrease tubular reabsorption and promote outflow of urine .

10. Thiazide Diuretics The mechanism of action of thiazide diuretics is primarily related to their ability to inhibit Na/CL symporters located in DCT. + -

11. Thiazide Diuretics Chlorthiazide Hydrochlorthiazide 1. 2.

12. Loop Diuretics They act by inhibiting the Na/K/ Cl symporters in the thick ascending loop of henle . Reabsorption decreases. Urine outflow. + + -

13. Loop Diuretics Furosimide Ethacrynic acid Cl

14. Potassium Sparing Agents 1. Aldosterone antagonist -: Spironolactone They permit the reabsorption of K and inhibit reabsorption of Na / Cl and associated water . + + -

15. Potassium Sparing Agents Amiloride . HCL 2.