Mechanism of action for major diuretics
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| Mannitol | Osmotic diuretic, ↑ tubular fluid osmolarity --> ↑ urine flow
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| Acetazolamide | Carbonic anhydrase inhibitor. Causes self-limited NaHCO3 diuresis and reduction in total body HCO-3 stores. Acts at proximal convoluted tubule. ACIDazolamide causes ACIDosis!
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| Furosemide | Sulfonamide loop diuretic. Inhibits costransport system (Na+, K++, 2 Cl-) of thick ascending limb. Abolishes hypertonicity of medulla, preventing concentration of urine. ↑ Ca++ excretion (Loops Loose CaLcium!)
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| Ethacrynic acid | Phenoxyacetic acid derivative. Same mechanism as furosemide. Used in pts with sulfa allergy.
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| Hydrochlorothiazide | Thiazide diuretic. Inhibits NaCl reabsorption in early distal tubule, reducing diluting capacity of nephron. ↓ Ca++ excretion.
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| Amiloride, triamterene | Na-channel blocking class of K+-sparing diuretics. Work in cortical collecting duct. Block Na+ reabsorption and K+ and H+ secretion.
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| Spironolactone | Competitive aldosterone receptor antagonist in cortical collecting duct. Reduces Na+ reabsorption and K+ and H+ secretion.
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| ↑ Urine NaCL | All diuretics
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| ↑ Urine K+ | All diuretics except K+-sparing
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| ↑ Blood pH (alkalosis) | Loop diuretics, thiazides
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| ↓ Blood pH (acidosis) | Carbonic anhydrase inhibitors, K+-sparing
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| ↑ Urine Ca++ | Loop diuretics
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| ↓ Urine Ca++ | Thiazides
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