Groups of diuretics
Full classification of diuretics would have to consider all aspects of their action. But today it does not exist, because diuretic drugs have totally different chemical structure. They differentiate too much from each other in the duration and mechanism of action on the organism of the patient.
Different groups of drugs have different effects on the kidneys. They help to excrete salt and water from the body.
Diuretics are mainly divided into the following groups:
- Loop diuretics (act on the cortical segment of the Henle loop). These water pills are the most powerful of existing diuretics.
- Potassium-sparing diuretics. Potassium-saving water pills also enhance the washing out of sodium ions, but at the same time lower the washing out of potassium ions.
- Osmotic diuretics. Osmotic diuretics do not block urine formation.
- Thiazides are very effective diuretics that belong to benzothiadiazole derivatives (Hydrochlorothiazide(Esidrix), Cyclopenthiazide).
Contraindications for diuretics use
Diuretics are prohibited in loss of kidney function. These preparations should not be prescribed during dehydration and to patients without signs of swelling.
Swelling caused by kidney disease (nephritis, etc.) can appear all over the body, but it is most clearly visible on the face, especially around the eyes. Renal swelling is usually soft to the touch, with pale skin around it. It is formed because unhealthy kidneys badly output salt and water. Protein concentration reduces in blood, while the permeability of vessel walls increases.
Different allergies and endocrine disorders are rare causes of swelling. If the patient observes swelling of the legs and it appears mostly in the evenings after work, it is likely to be caused by heart failure. Such symptom as swelling requires immediate examination to determine the cause. Only a qualified doctor should appoint the treatment.
Action of diuretics
Diuretics have different effect on urine formation, depending on their mechanism of action and its localization (different parts of the nephron), physical and chemical properties.
- Loop diuretics act throughout the raising part of the nephron loop and dramatically prevent the recapture of sodium and chlorine ions, increasing allocation of potassium ions. According to the chemical structure, they are derivatives of sulfamoyl anthranilic and dichlorophenoxyacetic acid (Furosemide(Lasix), Ethacrynic acid, Bumetanide etc. ). Loop diuretics and benzothiadiazole are useful in the treatment of hypertension and congestive heart failure. They increase the urine output, what results into the blood volume reduction.
- Osmotic diuretics increase the osmotic pressure of "primary urine" during filtration. This prevents water recapture in the proximal tubules. They can be prescribed during cerebral edema as dehydrating agents. The most active osmotic diuretics (Mannitol, etc. ) are used to cause diuresis in acute poisoning (by barbiturates, salicylates, etc.), acute renal failure, as well as acute heart failure in individuals with reduced kidney filtration.
- Diuretics, notably, diuretics of the thiazide group are used with other tension-lowering medicines or during monotherapy. Their effect develops mainly in the cortical segment of the nephron loop, where the reabsorption of cations is blocked. Besides, thiazides relax vascular wall directly. This leads to the change in the metabolic processes in the cell membranes of the arterioles, in particular, the sodium ion concentration is reduced, which reduces swelling and drop the peripheral vascular resistance. Thiazides change vascular reactivity and reduce the pressor reactions on vasoconstrictors (epinephrine). According to studies, thiazide water pills are more effective than beta-blockers.
- Potassium-saving diuretics are less effect than loop diuretics, but they do not provoke hypokalemia. They operate in the distal tubules where sodium and potassium ions are exchanged. The main representatives of this group of drugs are: spironolactone and triamterene. Those preparations are differ in their mechanism of action. Spironolactone is an aldosterone antagonist and its therapeutic activity is higher, the greater the level of production of aldosterone in the body. Triamterene is not an aldosterone antagonist. Under the influence of this preparation, sodium ions remain in the lumen of the tubule and hold water, which leads to increased diuresis.
Our online pharmacy offers you such diuretics as: Demadex, Lasix, Esidrix
- Demadex is used to diminish extra fluid in the body induced by liver or kidney disease or heart failure. It can also be used to lower high arterial tension. This prevents strokes, heart attacks, and kidney problems.
- Lasix is used to treat swelling in chronic heart failure, liver cirrhosis, kidney disease, acute heart failure (pulmonary edema), brain swelling, hypertensive crisis (independently or with other tension-lowering medicines), hypercalcemia, and eclampsia.
- Esidrix is used to treat swelling caused with liver cirrhosis, congestive heart failure, and estrogen or corticosteroid therapy. It also is used during different forms of arterial high tension.
- Diamox is one of the trademarks used to sell a substance named Acetazolamide. It has an ant-epileptic, water pill, and intraocular tension-lowering effects. It can be prescribed for glaucoma, epilepsy, swelling associated with heart diseases or other causes, altitude sickness, and so on.