Mechanism of Action

Indications

Precautions

Contraindications

Adverse Effects

Side Effects

Brand name/s

Remarks

Acetazolamide inhibit the enzyme Carbonic Anhydrase Inhibitors (e.g. acetazolamine, brinzolamine, dorzolamine) carbonic anhydrase which results to bicarbonate and potassium retention in urine and decrease in sodium absorption management of glaucoma, epilepsy, congestive heart failure and induced edema pregnancy & lactation, emphysema, impaired alveolar ventilation, rapid ascent to high altitude low sodium and potassium blood serum levels, suprarenal gland failure, hyperchloremic acidosis, marked renal or hepatic disease, cirrhosis Furosemide is used to prevent Thorough Prostatic prevent Loop Diuretics (e.g. furosemide, bumetanide, torsemide, ethacrynic acid) reabsorption of sodium, chloride and potassium in proximal and distal renal tubules and Henles loop for the treatment of hypertension and edema including pulmonary edema and with kidney and liver disorders hyperplasia or micturition impairment. Pregnancy & lactation. Normal blood pressure & circulating blood volume in shock patients. Pre-comatose states related with liver cirrhosis. Kidney failure due to nephrotoxic or hepatotoxic drugs and related to hepatic coma. Hypokalemia, hyponatremia, hypochloremic alkalosis, hyperglycemia, and nephrocalcinosis in preterm infants. Ototoxicity and hypersensitivity reactions Furosemide Diumide-K Edemann Frusema Fusimex Lasix bred and Standard bred race horses from nose bleeding during races. World Anti-Doping Agency included it to its banned drug list due to its suspected use as a concealing agent for other drugs. loss of appetite, acidosis, taste alteration, tinnitus, GI disturbances, drowsiness & confusion, polyuria malaise, fatigue, weight loss, depression, anorexia, acidosis, and loss of libido Cetamid Zolmide Brinzolamine Azarga Azopt Dorzolamine Cosopt Trusopt Carbonic anhydrase inhibitors use may cause higher blood and urine sugar concentrations which can cause in Type 2 Diabetes Mellitus.

Pregnancy and Manage fluid retention in act on the distal Thiazides (e.g. hydrochlorothiazi -de, metolazone, chlorothiazide, chlorthalidone) convoluted tubule and prevent the sodium-chloride symporter causing a retention of water in the urine patients with congestive heart failure, cirrhosis of the liver, or renal disorders, or edema caused by steroids or estrogen intake lactation, hypersensitivity to sulfa-drugs and penicillin, renal and hepatic disease, glaucoma, asthma and hypersensitivity to drugs, gout and diabetes Severe renal disease, cumulative effects of the drug may progress in patients with impaired renal function, impaired hepatic function or progressive liver disease

Alopecia, orthostatic hypotension, erythema multiforme including StevensJohnson syndrome, and exfoliative dermatitis including toxic epidermal necrolysis

Fast or uneven heartbeat, vision problems, dry mouth, thirst, nausea and vomiting, muscle pain or weakness, loss of appetite, dark urine, claycolored stools, and jaundice Muscle cramps and weakness, HCTZ Losartan + HCTZ Amvasc Plus CoAprovel Vascoride Ziac Usage reports show the possibility of activation of SLE (systemic lupus erythematosus).

Potassium Sparing Diuretics (e.g. spironolactone, amiloride, eplerenone) Prevent secretion of potassium in urine, decreases calcium in urine

Nephrogenic diabetes insidipus, mild heart failure, nephrolithiasis, and hypertension Low or normal aldosterone level

Acute liver insufficiency, anuria, Addisons disease, and pregnancy

Gastric problems including peptic ulcer, metabolic acidosis, gynecomastia, and hyperkalemia

skin rash, sleepiness or confusion, headache, aches and pains, diarrhea or constipation Spironolactone Aldactone Aldazide

Used in combination with thiazide or loop diuretics to help prevent hypokalemia

increase water Osmotic Diuretics (e.g. mannitol, isosorbide) absorption by the kidneys aggravating an increased urination, reduce increased intracranial pressure

Increase urine flow in acute kidney failure patients, short-term control of glaucoma, treat cerebral edema kidney failure, fluid and electrolyte imbalance

heart failure, pulmonary edema, cerebral malaria, intra cranial bleeding, patients with diminished cardiac reserve

Hypovolemia, polyuria, hypotension, pulmonary edema, seizures, electrolyte imbalance Dehydration, hypersensitivity reaction, blurred vision Isosorbide Isordil Isoket Available preparation: IV fluid

Water reabsorption Vasopressin Antagonists (e.g. colvaptan, tolvaptan) is reduced, plasma sodium concentration is increased and vasodilation is observed

Treatment of SIADH, postoperative hyponatremia, CHF, and cirrhosis Hypertension heart failure, kidney failure Polyuria, hypernatremia, thirst Dehydration, hypersensitivity reaction *No available brands in the Philippines

Recent studies show that Vasopressin antagonism is a future treatment option in heart failure.

References: Klabunde, R. E., (2012). Cardiovascular Pharmacology Concepts. http://www.cvpharmacology.com/diuretic/diuretics.htm UBM Medica Asia Pte Ltd. (2011). Master Index of Medical Specialities (MIMS). (130th Edition). Philippines: Ben Yao. Different Types of Diuretics, How They Work In The Body. (2010). http://www.askmedrug.com/5886 Carbonic Anhydrase Inhibitor (http://www.drugs.com/cons/carbonic-anhydrase-inhibitor-oral-parenteral.html) Diuretics (http://en.wikipedia.org/wiki/Diuretic) Diuretics (http://www.medschat.com/topics/diuretic-drug-list/) Diuretics (http://www.cvpharmacology.com/diuretic/diuretics.htm) Diuretics (http://www.icm.tn.gov.in/drug%20formulary/DIURETICS(14).htm) Diuretics (http://www.bupa.co.uk/individuals/health-information/directory/d/diuretics) Hydrochlorothiazides (http://www.drugs.com/pro/hydrochlorothiazide.html) Loop Diuretics (http://www.drugs.com/drug-class/loop-diuretics.html) Loop diuretics: Maximum effective dose and major side effects (http://www.uptodate.com/contents/loop-diuretics-maximum-effective-dose-and-major-side-effects) Potassium Sparing Diuretics (http://www.skeptictank.org/files/md001/ksparing.htm) Potassium Sparing Diuretics (http://www.patient.co.uk/health/potassium-sparing-diuretics)