LOADING AWESOME
LOADING AWESOME
DIURETICS
www.propofology.com
Dr. David Lyness
@Gas_Craic
1. Acetazolamide - carbonic anhydrase inhibitor - in proximal tube - when inhibited bicarbonate, sodium, and chloride are excreted rather than absorbed back in, carrying water with them. By excreting bicarb, it causes low blood CO2.
2. Osmotic Diuretics (Mannitol) -expands extracellular fluid and plasma volume, therefore increasing blood flow to the kidney. This washes out the cortical medullary gradient in the kidney. This stops the loop of Henle from concentrating urine, which usually uses the high osmotic and solute gradient to transport solutes and water.
3. Loop Diuretics (Furosemide) - inhibits Na-K-2Cl symporter in the thick ascending limb. Can lead to loss of potassium. It's not limited by acidosis whereas carbonic anhydrase inhibitors are.
4. Thiazides (HCTZ) - inhibits reabsorption of sodium and chloride ions from the distal convoluted tubules in the kidneys by blocking the thiazide-sensitive Na+/Cl symporter. Also increases calcium reabsorption at the distal tubule.
5. Potassium Sparing (Spironolactone) - Androgen antagonist. Prevents the production of proteins that are normally synthesized in reaction to aldosterone = stimulation of sodium-potassium exchange sites in the collection tubule does not occur. This prevents sodium re-absorption and potassium and hydrogen ion secretion.
Diuretics often inhibit the reabsorption of electrolytes into the main blood stream and thus keep or draw in water to the lumen of the tubules and excrete it out in the urine.
