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main purpose of diuretics
increase urine output
eliminate excess fluid from the body
lowers blood pressure
at level of umbilicus
22% of cardiac output
decreased blood flow to it can cause renal damage or failure
20% of total blood flow thru nephron
99% reabsorbed in tubules
1% excreted as urine
adult output = 30 to 60 ml/hour
is a mineralocorticoide secreted by the adrenal cortex
increases NA & H2O reabsorption in distal tubule
5 major diuretic groups
carbonic anhydrase inhibitors
increase diuresis of sodium bicarbonate
poor diuretic b/c ends up being reabsorbed in the loop of Henle
inhibitors block Na & HCO3 in PCT
Loop diuretics KNOW
inhibit the reabsorption of Na, Cl
the most potent diuretics
use for pulmonary edema, renal failure, CHF, heart failure, edema
act principally at the thick ascending limb of the loop of Henle
block Na & Cl reabsorption in the distal tubule
less potent than loop
indications: mild edema, HTN
block reabsorption of NaCl in the proximal tubule & descending limb of the loop of Henle
up to 20% of filtered load NaCl & water to be excreted in the urine
short half life
maintained continued diuretic action
used with head injury
block reabsorption of Na in the distal tubule
in the distal tubule:
Na is exchanged for potassium & hydrogen
blocking this exchange makes these agents potassium sparing diuretics
volume depletion & electrolyte imbalance - most common
hypokalemia thru volume loss & electrolyte shifts-loops especially
acid base imbalance
tinnitus & hearing loss
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