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Diuretics By S.Bohlooli, PhD.

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Presentation on theme: "Diuretics By S.Bohlooli, PhD."— Presentation transcript:

1 Diuretics By S.Bohlooli, PhD

2 Renal Tubular Transport Mechanism
Proximal Tubule Loop of Henle Distal Convoluted Tubule Collecting Tubule

3 Renal Tubular Transport

4 Basic Pharmacology of Diuretic agents
Carbonic anhydrase inhibitors Loop diuretics Thiazides Potassium-sparing diuretics

5 Carbonic anhydrase inhibitors

6 NaHCO3 reabsorption in proximal tubule and mechanism of diuretic action of carbonic anhydrase inhibitors

7 Applications Glaucoma Urinary alkalinization Metabolic alkalosis
Acute mountain disease Epilepsy, hypokalemic periodic paralysis

8 Toxicity Hyperchloremic metabolic acidosis Renal stones
Renal potassium wasting Hypersensivity reactions Contraindicated in patients with cirrhosis

9 Loop diuretics

10 Loop diuretics

11 NaCl reabsorption in thick ascending limb and mechanism of diuretic action of Na+-K+-2Cl- symport inhibitors

12 Applications Acute pulmonary edema Acute hypercalcemia Hyperkalemia
Acute renal failure Anion overdose

13 Toxicity Hypokalemic metabolic acidosis Ototoxicity Hyperuricemia
Hypomagnesimia Allergic reactions Contraindicated in hepatic cirrhosis, borderline renal failure and heart failure

14 Thiazides

15 Thiazides

16 Thiazides

17 Applications Hypertension Heart failure Nephrolithiasis
Nephrogenic diabetes

18 Toxicity Hypokalemic metabolic alkalosis Hyperuricemia
Impaired carbohydrate tolerance Hyperlipidemia Hyponatremia Allergic reactions

19 Potassium-sparing diuretics: channel blockers

20 Potassium-sparing diuretics

21 ANTAGONISTS OF MINERALOCORTICOID RECEPTORS

22 ANTAGONISTS OF MINERALOCORTICOID RECEPTORS

23 Applications State of mineralocorticoid excess

24 Toxicity Hyperkalemia Hyperchloremic metabolic acidosis Gynecomastia
Acute renal failure: triamterene & indomethacin Kidney stones: triamterene is insoluble

25 Diuretics: summery

26 Clinical Pharmacology of Diuretic Agents
Edematous states Heart Failure Kidney Diseases Hepatic cirrhosis Idiopatic edema Nonedematous states Hypertension Nerphrolithiasis Hypercalcemia Diabetes insipidus

27 Good Luck

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