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Diuretics are a class of medications widely used in clinical practice to manage a variety of conditions, primarily those involving fluid overload and hypertension. By promoting the excretion of sodium and water from the body through the kidneys, diuretics play a crucial role in reducing blood volume, alleviating edema, and lowering blood pressure. They are commonly used in the management of heart failure, chronic kidney disease, liver cirrhosis, and hypertension.
Class of Diuretic | Mechanism of Action | Examples | Clinical Applications | Side Effects | Clinical Considerations |
---|---|---|---|---|---|
Thiazide Diuretics | Inhibit sodium and chloride reabsorption in the distal convoluted tubule | Chlorthalidone, Hydrochlorothiazide, Metolazone, Indapamide | First-line treatment for hypertension, management of mild heart failure and edema, prevention of kidney stones | Hypokalemia, hyperglycemia, hyperlipidemia, hyperuricemia (may precipitate gout) | Often combined with other antihypertensives, monitor serum electrolytes, especially potassium; may require dose adjustment in renal impairment |
Loop Diuretics | Inhibit the sodium-potassium-chloride cotransporter in the thick ascending limb of the loop of Henle | Furosemide, Bumetanide, Torsemide | Treatment of acute and chronic heart failure, severe edema, hypercalcemia, hypertensive emergencies | Hypokalemia, hypomagnesemia, ototoxicity (especially at high doses) | Most potent diuretics, essential in heart failure management, close monitoring of electrolytes, especially potassium and magnesium, is necessary |
Potassium-Sparing Diuretics | Block aldosterone receptors or... |
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