Diuretics & Anti-diuretics (Pharmacology) Handwritten Notes
Comprehensive pharmacology notes covering urinary system drugs including:
- Classification of diuretics
- Mechanisms of action
- High-ceiling (loop) diuretics
- Anti-diuretic agents
- Clinical applications
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Comprehensive Pharmacology of Diuretics & Anti-diuretics
Classification of Diuretics
- High Efficacy Diuretics:
- Furosemide, Bumetanide, Torasemide
- Inhibit Na+-K+-2Cl¯ cotransport
- Medium Efficacy Diuretics:
- Thiazides: Hydrochlorothiazide, Bendroflumethiazide
- Thiazide-like: Chlorthalidone, Indapamide
- Weak/Adjunctive Diuretics:
- Carbonic anhydrase inhibitors (Acetazolamide)
- K+-sparing diuretics (Spironolactone, Amiloride)
- Osmotic diuretics (Mannitol)
High Ceiling (Loop) Diuretics
Furosemide (Prototype Drug):
- Mechanism: Blocks Na+-K+-2Cl¯ cotransport in thick ascending limb of Henle
- Features:
- Rapid action (IV: 2-5 min, Oral: 20-40 min)
- Short duration (3-6 hours)
- Effective in renal failure patients
- Effects:
- Produces up to 10L urine/day at high doses
- Disrupts corticomedullary osmotic gradient
- Increases K+ excretion
Clinical Applications
- Edema management (cardiac, hepatic, renal)
- Hypertension treatment
- Acute pulmonary edema
- Hypercalcemia management
Anti-diuretics
- Vasopressin analogs (Desmopressin)
- Thiazide diuretics (paradoxical effect in diabetes insipidus)
- Mechanisms:
- Increase water reabsorption in collecting ducts
- Reduce urine output
Pharmacokinetic Considerations
- Furosemide secretion via organic anion transport
- Thiazides' long duration of action (6-12 hours)
- Spironolactone's slow onset (2-3 days)
Adverse Effects
- Hypokalemia (thiazides/loop diuretics)
- Hyperkalemia (K+-sparing diuretics)
- Ototoxicity (loop diuretics)
- Metabolic alkalosis
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