Anti-hypertensive ( diuretic part 2 )
The uses:
1- Thiazide:
A) hypercalciurea : calcium oxalate stones in the urinary tract.
B) preserves bone mineral density at hip and may reduce the risk of fractures.
2- loop diuretic:
A) Acute pulmonary edema.
B) Acute or chronic Peripheral edema caused from heart failure or renal impairment.
C) Emergency (Rapid)
D) Hypercalcemia.
E) Hyperkalemia.
3- spironolactone:
A) Conjugated with thiazide or loop diuretics to prevent K+ excretion.
B) Hepatic cirrhosis- induced edema.
C) Hyperaldosteronism
D) Hirsutism in women
E) Heart failure
F) Resistant Hypertension
G) Ascites
H) Polycystic ovary
4- Acetazolamide:
A) Mountain Sickness such as: nausea, pulmonary edema, breathlessness and Weakness.
B) Glaucoma Aqueous humor form ciliary body of eye.
5- osmotic:
A) Acute renal failure due to shock.
B) High intracranial pressure.
Side effect:
1- Thiazide:
Hyperuricemia
orthostatic hypotension
Hypokalemia
Hypomagnesemia
Hyponatremia
Hypercalcem
Hyperglycemia
2- loop diuretic:
Hyperuricemia
Acute hypovolemia
Hypokalemia
Hypomagnesemia
Hypocalcemia
3- potassium sparing:
Hyperuricemia
Gynecomastia
Menstrual egularities
Hyperkalemia
Lethargy
Mental confusion
Gastrointestinal tract upset
Renal stones
4- carbonic anhydrase inhibitors:
metabolic acidosis
Renal Stone formation
Drowsiness
Parathesia
5- osmotic:
Dehydration
Drug interactions:
1- NSAIDs: acts to inhibit production of renal prostaglandins , which leads to a decrease renal blood flow ( avoid coadminstration)
2- ACE inhibitors : acts as synergistic hyperkalemia , which leads to a arrhythmia weakness ( avoid coadminstration )
3- potassium supplement: acts as synergistic hyperkalemia , which leads to a arrhythmia weakness ( avoid coadminstration )