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Diuretics Notes

Medicine Notes > Renal System Notes

This is an extract of our Diuretics document, which we sell as part of our Renal System Notes collection written by the top tier of Bristol University students.

The following is a more accessble plain text extract of the PDF sample above, taken from our Renal System Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

Lecture 16 Diuretics

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General o Classified in 5 groups
? OSMOTIC
? CARBONIC ANHYDRASE INHIBITORS
? LOOP
? THIAZIDES
? POTASSIUM SPARING o Why diuretics?
? Heart failure

* Activation of rennin-angiotensin system

* Retention of sodium and water/increase in blood volume

* Elevated venous pressure- pulmonary and systemic oedema
? Hypertension

* High renin-angiotensin release and vasoconstriction, aldosterone secretion and salt retention

* Low renin-sodium retention due to increased sympathetic adrenergic activity or a defect in sodium-couple calcium transport
? Other oedema

* Renal-nephrotic syndrome, renal failure

* Liver failure OSMOTIC DIURETICS- MANNITOL, UREA o Elevate osmotic pressure of glomerular filtrate to an extent that tubular reabsorption of water and solutes (mainly Na) are hindered o Mannitol
? Indications

* Oliguric acute renal failure

* During CVS surgery

* Reduction of intracranial pressure prior to and during neurosurgery

* During any surgery for patients with poor renal function

* Treat acute toxicities with so drugs such as barbiturates, salicylates, imipramine

*Treat oedema & ascitis of nephrotic, cirrhotic, and cardiac origin

Precautions and contraindications

* Patients with shock & oliguria: mannitol should not be given until fluid, plasma, blood, and electrolytes have been replaced

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It is contraindicated in well established renal failure o

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A test dose is usually given before use

CARBONIC ANHYDRASE INHIBITORS- ACETAZOLAMIDE

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