-semide ending

high ceiling diuretic

Inhibition of Na/2Cl/K cotransporter at thick ascending loop of Henle

causes smooth muscle relaxation

GFR and RPF unchanged

• low K, Cl, Mg (give Mg)
• cardiac arrhythmias
• low Ca (used as treatment for hypercalcemia
• high uric acid (competitive inhibition of PSOASS, which removes uric acid)
• high glucose, high TGs, low HDL, high pH (alkalosis --> hypokalemia)
• ototoxicity (cochlear>vestibular), increased with aminoglycosides and cisplatin

treatment of gout

microtubule inhibition

acute renal failure

pulmonary edema

increased intracranial pressure

increased intraocular pressure/glaucoma

increased bp (if thiazides don't work)

cardiac insufficiency

renal insufficiency

low ceiling diuretic

-thiazide ending

Inhibition of Na/Cl cotransport in early distal tubule, secreted actively (like loops)

increases urine volume modestly, but decreased in DI

increased uric acid

decreased carbonic anhydrase

decreased GFR and RPF

do not use in ARF, no IV

low K, Mg, Cl

high plasma Ca, low urine Ca

increase glucose, TG, low HDL

increased bp

cardiac insufficiency and edema

diabetes insipidus

urinary Ca stones

combine with potassium sparing drug: aldosterone antagonists, cycloamidine derivatives

aldosterone antagonists (eg spironolactone)

and

cycloamidine derivatives (eg triamterene, which depletes folic acid)

not diuretic use on their own

spironolactone + cycloamidine

ACE + any K sparing

K supplements + ACE or any K sparing

due to danger of hyperkalemia

acetazolamide

secreted into tubule(?), inhibits CA in early proximal tubule

rare use as diuretic, mainly used to maintain pH, induces acidosis in blood (and alkalosis in urine)

used for prevention of mountain sickness, glaucoma, sequential nephron blockade

caffeine, theophylline, theobromine

at low [], adenosine-1 receptor blocker, which causes vasoconstriction of the efferent kidney arteriole