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Diuretic agents
Learning objectives
Upon completion of this chapter, you should be able to:
1.
Define the term diuretic and list the five classes of diuretics.
2.
Describe the therapeutic actions, indications, pharmacokinetics, contraindications and cautions, most
common adverse reactions, and important drug–drug interactions associated with the various classes of
diuretic drugs.
3.
Discuss the use of diuretic agents across the lifespan.
4.
Compare and contrast the prototype drugs of each class of diuretic drugs with other agents in their class.
5.
Outline the care considerations, including important teaching points, for people receiving diuretic agents.
Glossary of key terms
alkalosis:
state of not having enough acid to maintain normal homeostatic processes; seen with loop diuretics, which cause loss of
bicarbonate in the urine
fluid rebound:
reflex reaction of the body to the loss of fluid or sodium; the hypothalamus causes the release of antidiuretic hormone,
which promotes water retention, and stress related to fluid loss combines with decreased blood flow to the kidneys to activate the
renin–angiotensin–aldosterone system, leading to further water and sodium retention
high-ceiling diuretics:
powerful diuretics that work in the loop of Henle to inhibit the reabsorption of sodium and chloride, leading to
a sodium-rich diuresis
hyperaldosteronism:
excessive output of aldosterone from the adrenal gland, leading to increased sodium and water retention and
loss of potassium
hypokalaemia:
low potassium in the blood, which often occurs after diuretic use; characterised by weakness, muscle cramps,
trembling, nausea, vomiting, diarrhoea and cardiac arrhythmias
oedema:
movement of fluid into the interstitial spaces; occurs when the balance between osmotic pull (from plasma proteins) and
hydrostatic push (from blood pressure) is disturbed
osmotic pull:
drawing force of large molecules on water, pulling it into a tubule or capillary; essential for maintaining normal fluid
balance within the body; used to draw out excess fluid into the vascular system or the renal tubule
saluretic effect:
relating to or causing excretion of salt
Test your current knowledge of diuretic agents with a PrepU Practice Quiz!
DIURETICS
Thiazide diuretics and
thiazide-like diuretics
Thiazide diuretics
hydrochlorothiazide
Thiazide-like diuretics
chlorthalidone
indapamide
Loop diuretics
bumetanide
ethacrynic acid
frusemide
Carbonic anhydrase inhibitors
acetazolamide
brinzolamide
Potassium-sparing diuretics
amiloride
eplerenone
spironolactone
triamterene
Osmotic diuretics
glucose
mannitol
