Drugs MOA @ Pharmacokinetics @ Pharm.

Effects Therapeutical Uses Adverse Effects

Diuretics
1. Loop diuretics
Furosemide MAO (Decrease Na and H2O retention by acting at 1. Edema: associated with CHF, liver and renal 1. Hypokalemic metabolic alkalosis
henle loop) disease (including nephrotic syndrome) 2. Hyponatremia
- Inhibits the Na- K- 2C1 symporter in the luminal 2. Pulmonary edema 3. Hypochloremia
membrane of the thick ascending limb of the 3. Treatment of HF from the very beginning of 4. Hypomagnesemia
loop of Henle (TALH) by interfering with the the disease
5. Hyperuricemia leading to gouty attacks
Cl- binding site of this symporter. Delivery of 4. Hypertension ( reserved for patients refractory
these electrolytes to distal regions of the to other diuretics).
6. Hypercalciuria: leading to kidney- stone
nephron results in secretion of K and H formation
5. Hypercalcemia: due to the stimulation of
(hypokalemic alkalosis). t u b u l a r Ca2 secretion
7. Orthostatic hypotension
(hypovolemia)
Bumetamide Similar as furosemide but 10-40x more potents 8. Allergic reactions
Torsemide has a longer t 1/2 9. Decrease VLDL and increase
Ethacrynic acid HDL
10. Fatigue

2. Thiazide diuretics
Hydrochlorolhiazide, 1. Hypokalemic metabolic alkalosis
MAO (decrease Na and H2O retention by acting 1. Hypertension (mild to severe) in patients
Chlortalidone, Indapamide, 2. Hyponatremia
at early part of proximal convoluted tubules) with low plasma renin and increased plasma
Metolazone 3. Hypochloremia
- Inhibit the Na-Cl symporter on the lumenal volume.
4. Hypomagnesemia
side of the epithelial cells in the early distal 2. Edema associated with CHF, hepatic
convoluted tubules (DCT) resulting in 5. Hyperuricemia leading to gouty attacks
disease, renal disease and corticosteroids
decreased reabsorption of NaCl. therapy.
6. Hypercalciuria: leading to kidney- stone
formation
- This decrease in Na reabsorption promotes 3. Nephrogenic diabetes insipidus: thiazide 7. Orthostatic hypotension
Na-Ca exchange which leads to diuretics decrease urine volume, due to (hypovolemia)
hypercalcemia and H2Oexcretion. volume contraction which loads to increased 8. Allergic reactions
proximal tubular reabsorption. 9. Hyperglycemia: decrese insulin
4. Ca nephrolithiasis release
10. Hyperlipidemia: increase
cholesterol and triglycerides
11. Photosensitivity

Vasodilators
Hydralazine 1. Headache
MAO 1. Hypertension (moderate to severe): used in 2. Nausea
combination with a diuretic to decrease sodium 3. Diarrhea
- Direct vasodilator of arteriolar smooth muscle
retention and a B-blocker or nitrate to prevent
resulting in decrease in PVR but may induce 4. Cardiovascular effects: hypotension,
reflex tachycardia.
reflex increase in sympathetic tone (increase HR palpitations, tachycardia and angina
and CO and fluid retention). It reduces only 2. Congestive heart failure pectoris
after-load 5. Lupus-like syndrome
6. Edema
- Increases renal blood How. 7. Contraindications: Dissecting aortic
aneurysm and Coronary artery disease
Minoxidil MAO 1. Hypertension: used in combination with a 1. Edema
- Arteriolar smooth muscle vasodilator. diuretic to decrease sodium retention and a B- 2. Reflex tachycardia
- Minoxidil increase K efflux by opening K blocker or nitrate to prevent reflex tachycardia 3. Flushing
4. Hypertrichosis (increased hair growth)