This illustration shows where some types of diuretics act, and what they do.

A diuretic is any drug that elevates the rate of urination (diuresis). A drug, broadly speaking is any chemical substance that when absorbed into the body Urination, also known as micturition, voiding, and more rarely emiction, is the process of disposing Urine from the Urinary bladder Diuresis is the increased production of Urine by the Kidney. Types and causes The kidney normally produces up to 180 L of "pro-urine" There are several categories of diuretics. All diuretics increase the excretion of water from the body, although each class of diuretic does so in a distinct way.

High ceiling loop diuretics

High ceiling diuretics are diuretics that may cause a substantial diuresis - up to 20%^[1] of the filtered load of NaCl and water. For sodium chloride in the diet see Salt. Sodium chloride, also known as common salt, table salt, or Halite, is a This is huge, compared to that normal renal sodium reabsorption leaves only ~0. Renal reabsorption of sodium ( Na+) is a part of Renal physiology. 4% of filtered sodium in the urine.

Loop diuretics have this ability, and are therefore often synonymous with high ceiling diuretics. Loop diuretics are Diuretics that act on the ascending Loop of Henle in the Kidney. Loop diuretics, such as furosemide, inhibit the body's ability to reabsorb sodium at the ascending loop in the kidney which leads to a retention of water in the urine as water normally follows sodium back into the extracellular fluid (ECF). Furosemide ( INN) or frusemide (former BAN) is a Loop diuretic used in the treatment of congestive Heart failure and Edema Sodium (ˈsoʊdiəm is an element which has the symbol Na( Latin natrium, from Arabic natrun) atomic number 11 atomic mass 22 The kidneys are complicated organs that have numerous biological roles Other examples of high ceiling loop diuretics include ethacrynic acid, torsemide and bumetanide. Torasemide ( rINN) or torsemide ( USAN) is a Pyridine - Sulfonyl[[urea]] type Loop diuretic mainly used in the management Bumetanide is a Loop diuretic

Thiazides

Drugs such as hydrochlorothiazide act on the distal tubule and inhibit the Sodium-chloride symporter leading to a retention of water in the urine as water normally follows penetrating solutes. Hydrochlorothiazide, sometimes abbreviated HCT, HCTZ, or HZT is a popular Diuretic drug of the Thiazide class that acts by inhibiting The sodium-chloride symporter is a Symporter Ion pump used primarily to remove Sodium and Chloride Ions from the Distal convoluted

Potassium-sparing diuretics

These are diuretics which do not promote the secretion of potassium into the urine; thus, potassium is spared and not lost as much as in other diuretics. Potassium (pəˈtæsiəm is a Chemical element. It has the symbol K (kalium from qalīy Atomic number 19 and Atomic mass 39 Such drugs include spironolactone which is a competitive antagonists of aldosterone. Spironolactone (marketed under the trade names Aldactone, Novo-Spiroton, Spiractin, Spirotone, Verospiron or Berlactone A competitive antagonist is a Receptor antagonist that binds to a receptor but does not activate the receptor Aldosterone is a hormone that causes the tubules of the kidneys to retain sodium and water Aldosterone normally adds sodium channels in the principal cells of the collecting duct and late distal tubule of the nephron. Aldosterone is a hormone that causes the tubules of the kidneys to retain sodium and water Spironolactone prevents aldosterone from entering the principal cells, preventing sodium reabsorption. Other examples of potassium-sparing diuretics are amiloride and triamterene. Amiloride is a potassium-sparing diuretic, first approved for use in 1967 (then known as MK 870 used in the management of Hypertension and Congestive Triamterene (trade name Dyrenium) is a Potassium-sparing diuretic used in combination with Thiazide diuretics for the treatment of Hypertension

Osmotic diuretics

Compounds such as mannitol are filtered in the glomerulus, but cannot be reabsorbed. Mannitol or hexan-123456-hexol (C6H8(OH6 is a Polyol that is used as an osmotic Diuretic agent and a A glomerulus is a Capillary tuft surrounded by Bowman's capsule in Nephrons of the vertebrate Kidney. Their presence leads to an increase in the osmolarity of the filtrate. To maintain osmotic balance, water is retained in the urine.

High Blood Glucose

Glucose, like mannitol, is a sugar that can behave as an osmotic diuretic. Glucose (Glc a Monosaccharide (or simple Sugar) also known as grape sugar, is an important Carbohydrate in Biology. Unlike mannitol, glucose is commonly found in the blood. However, in certain conditions such as diabetes mellitus, the concentration of glucose in the blood exceeds the maximum resorption capacity of the kidney. Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc When this happens, glucose remains in the filtrate, leading to the osmotic retention of water in the urine. Use of some drugs, especially stimulants may also increase blood glucose and thus increase urination. A drug, broadly speaking is any chemical substance that when absorbed into the body Stimulant drugs are Drugs that temporarily increase alertness and awareness

Uses

In medicine, diuretics are used to treat heart failure, liver cirrhosis, hypertension and certain kidney diseases. Medicine is the art and science of healing It encompasses a range of Health care practices evolved to maintain and restore Human Health by the Heart failure is a Cardiac condition that occurs when a problem with the structure or function of the Heart impairs its ability to supply Cirrhosis is a consequence of chronic Liver Disease characterized by replacement of liver tissue by fibrous Scar tissue as well as regenerative Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the Blood pressure is chronically elevated Nephrology (from Greek nephros, " Kidney " and λόγος Logos, "speech" lit Some diuretics, such as acetazolamide, help to make the urine more alkaline and are helpful in increasing excretion of substances such as aspirin in cases of overdose or poisoning. Acetazolamide, sold under the trade name Diamox, is a Carbonic anhydrase inhibitor that is used to treat Glaucoma, Epileptic seizures Benign Urine is a liquid waste product of the body secreted by the Kidneys by a process of filtration from Blood and Excreted through the Urethra. In Chemistry, an alkali (from Arabic: Al-Qaly القلي القالي) is a basic, ionic salt of an Alkali metal Aspirin, or acetylsalicylic acid (ASA (əˌsɛtɨlsælɨˌsɪlɨk ˈæsɨd is a Salicylate drug, often used as an Analgesic to relieve The term drug overdose (or simply overdose or OD) describes the Ingestion or application of a Drug or other substance in quantities Diuretics are often abused by sufferers of eating disorders, especially bulimics, in attempts at weight loss. An eating disorder is a compulsion to eat or avoid eating that negatively affects both one's physical and mental health Bulimia nervosa is an Eating disorder characterized by recurrent Binge eating, followed by compensatory behaviors referred to as "purging"

The antihypertensive actions of some diuretics (thiazides and loop diuretics in particular) are independent of their diuretic effect. Thiazide is a term used to describe a type of molecule and a class of Diuretic. Loop diuretics are Diuretics that act on the ascending Loop of Henle in the Kidney. That is, the reduction in blood pressure is not due to decreased blood volume resulting from increased urine production, but occurs through other mechanisms and at lower doses than that required to produce diuresis. Indapamide was specifically designed with this in mind, and has a larger therapeutic window for hypertension (without pronounced diuresis) than most other diuretics. Indapamide is a non-thiazide sulphonamide Diuretic drug marketed by Servier, generally used in the treatment of Hypertension, as well as

Mechanism of action

Classification of common diuretics and their mechanisms of action:

Chemically, diuretics are a diverse group of compounds that either stimulate or inhibit various hormones that naturally occur in the body to regulate urine production by the kidneys. Hormones (from Greek ὁρμή - "impetus" are chemicals released by cells that affect cells in other parts of the body Herbal medications are not inherently diuretics. A(n herb (ˈhɝb or /ˈɝb/ see pronunciation differences) is a plant that is valued for qualities such as medicinal properties flavor scent or the like They are more correctly called aquaretics. An aquaretic is a class of drug that is used to promote Aquaresis.

Adverse effects

The main adverse effects of diuretics are hypovolemia, hypokalemia, hyperkalemia, hyponatremia, metabolic alkalosis, metabolic acidosis and hyperuricemia ^[2]. In Physiology and Medicine, hypovolemia (also hypovolaemia is a state of decreased Blood volume more specifically decrease in volume of Blood plasma Hypokalemia refers to the condition in which the concentration of Potassium in the blood is low Hyperkalemia ( AE) or Hyperkalaemia ( BE) is an elevated blood level of the Electrolyte Potassium. Hyponatremia ( British: hyponatraemia) is an Electrolyte disturbance (disturbance of the salts in the blood in which the Sodium ( Natrium Metabolic alkalosis is a Metabolic condition in which the PH of the blood is elevated beyond the normal range In Medicine, metabolic acidosis is a process which if unchecked leads to acidemia (i Hyperuricemia ( American English) or hyperuricaemia ( British English) is the presence of high levels of Uric acid in the blood Each are at risk of certain types of diuretics and present with different symptoms.

References

External links

• Diagram at cvpharmacology.com